{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:25:40Z","timestamp":1788326740525,"version":"build-2803163510"},"reference-count":18,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Children's Orthopaedics"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The neck\u2013shaft angle and head\u2013shaft angle in children with varying levels of neurological disability were evaluated to define change over different ages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Children aged 1\u201312\u2009years with spastic cerebral palsy, spinal muscular atrophy types 1 and 2, or typical development were reviewed to evaluate the neck\u2013shaft angle and head\u2013shaft angle. Patients were divided into five groups: Gross Motor Function Classification System levels I and II, Gross Motor Function Classification System level III, Gross Motor Function Classification System levels IV and V, spinal muscular atrophy types 1 and 2, and typical development. A linear mixed model was utilized to evaluate neck\u2013shaft angle and head\u2013shaft angle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Data from 196 children (mean age 4.8\u2009\u00b1\u20094.5\u2009years) were included. Gross Motor Function Classification System levels I and II: 22 children, 130 hip radiographs measured, neck\u2013shaft angle 143.7\u2009\u00b1\u20097.4, and head\u2013shaft angle 160.0\u2009\u00b1\u20097.1. Gross Motor Function Classification System level III: 8 children, 33 hips evaluated, neck\u2013shaft angle 153.1\u2009\u00b1\u20094.3, and head\u2013shaft angle 163.4\u2009\u00b1\u20094.2. Gross Motor Function Classification System levels IV and V: 30 children, 137 hip radiographs measured, neck\u2013shaft angle 156.4\u2009\u00b1\u20095.6, and head\u2013shaft angle 167.9\u2009\u00b1\u20096.8. Spinal muscular atrophy types 1 and 2: 32 children, 83 hip radiographs measured, neck\u2013shaft angle 161.9\u2009\u00b1\u20099.7, and head\u2013shaft angle 173.4\u2009\u00b1\u20097.4. Typical development: 104 children, 222 hip radiographs measured, neck\u2013shaft angle 138.6\u2009\u00b1\u20097.0, and head\u2013shaft angle 156.4\u2009\u00b1\u20095.9. There were significant statistical differences when comparing neck\u2013shaft angle and head\u2013shaft angle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>As children grow, neck\u2013shaft angle and head\u2013shaft angle tend to decrease in typical development and Gross Motor Function Classification System levels I and II groups. However, in low-tone (spinal muscular atrophy types 1 and 2) and high-tone groups (Gross Motor Function Classification System levels IV and V), neck\u2013shaft angle and head\u2013shaft angle tend to increase with age. In both low-tone and high-tone groups, coxa valga is observed. When evaluating the effect of proximal femur-guided growth, these defined normal growth patterns should be considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III Retrospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/18632521241277023","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T10:40:58Z","timestamp":1725964858000},"page":"523-530","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Femoral neck\u2013shaft angle changes based on the severity of neurologic impairment in children with cerebral palsy and spinal muscular atrophy"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7464-4269","authenticated-orcid":false,"given":"Luiz Carlos","family":"Almeida da Silva","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Nemours Children\u2019s Health, Wilmington, DE, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5921-3479","authenticated-orcid":false,"given":"Yusuke","family":"Hori","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nemours Children\u2019s Health, Wilmington, DE, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burak","family":"Kaymaz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nemours Children\u2019s Health, Wilmington, DE, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4157-6009","authenticated-orcid":false,"given":"Kenneth J","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nemours Children\u2019s Health, Wilmington, DE, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Trionfo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nemours Children\u2019s Health, Wilmington, DE, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Richard","family":"Bowen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nemours Children\u2019s Health, Wilmington, DE, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3049-6345","authenticated-orcid":false,"given":"Jason J","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nemours Children\u2019s Health, Wilmington, DE, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Wade","family":"Shrader","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nemours Children\u2019s Health, Wilmington, DE, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0033-5623","authenticated-orcid":false,"given":"Freeman","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nemours Children\u2019s Health, Wilmington, DE, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"key":"bibr1-18632521241277023","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.12169"},{"key":"bibr2-18632521241277023","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.97B9.35655"},{"key":"bibr3-18632521241277023","doi-asserted-by":"publisher","DOI":"10.1177\/18632521221084184"},{"key":"bibr4-18632521241277023","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12041651"},{"key":"bibr5-18632521241277023","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B10.20733"},{"key":"bibr6-18632521241277023","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00676"},{"issue":"5","key":"bibr7-18632521241277023","first-page":"609","volume":"9","author":"Lebe M","year":"2022","journal-title":"Children (Basel)"},{"key":"bibr8-18632521241277023","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-196749050-00001"},{"key":"bibr9-18632521241277023","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198567080-00014"},{"key":"bibr10-18632521241277023","unstructured":"R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https:\/\/www.R-project.org\/ (2021, accessed 1 April 2024)."},{"key":"bibr11-18632521241277023","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-50592-3_125-1"},{"key":"bibr12-18632521241277023","doi-asserted-by":"publisher","DOI":"10.21037\/tp.2020.01.01"},{"key":"bibr13-18632521241277023","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-6-71"},{"key":"bibr14-18632521241277023","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-015-0654-z"},{"key":"bibr15-18632521241277023","doi-asserted-by":"publisher","DOI":"10.1177\/18632521221113424"},{"key":"bibr16-18632521241277023","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001875"},{"key":"bibr17-18632521241277023","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-24520-1"},{"key":"bibr18-18632521241277023","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2018.00788"}],"container-title":["Journal of Children's Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/18632521241277023","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/18632521241277023","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/18632521241277023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:09:45Z","timestamp":1777388985000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/18632521241277023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,10]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1177\/18632521241277023"],"URL":"https:\/\/doi.org\/10.1177\/18632521241277023","relation":{},"ISSN":["1863-2521","1863-2548"],"issn-type":[{"value":"1863-2521","type":"print"},{"value":"1863-2548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,10]]}}}