Children with Developmental Challenges

Children With Developmental Challenges 3(2+1)

Lesson 9 : Cerebral Palsy Effects, Diagnosis and Treatment

Role Of Orthopedic Surgeon

The aim of orthopedic treatment in cerebral palsy is to

1. Restore grip & reach for the hand.
2. Give stability for standing.
3. Enable the child's lower extremity for walking

These aims can be reached initially by conservative means. But when it is apparent that progressive deformity is developing or has already developed in spite of non-surgical treatment, surgery is indicated.

Orthopedic Management

1. Non surgical
   1. Plaster Application over a period of3-6 weeks to straighten the joint or to lengthen tight muscles.
   2. Injecting medicine-in the muscle to decrease tightness (Botox injection)


2. Surgical:
   1. Muscles: Working muscle transferred for non-working ones (tendon transfer).
   2. Tendon: Tight tendons cut & lengthened (tenoplasty).
   3. Nerves: Nerves supplying to tight muscles cut so as to decrease tightness (Neurectomy).
   4. Bone:
   1. Bones cut & re-aligned to correct abnormal position of joint (osteotomy)
   2. Joints fixed in normal position (arthrodesis).