The orthopaedic aspect of spastic cerebral palsy
- PMID: 33214743
- PMCID: PMC7658655
- DOI: 10.1016/j.jor.2020.11.002
The orthopaedic aspect of spastic cerebral palsy
Abstract
Spastic Cerebral Palsy (CP) is the most common form of CP, comprising of 80% of all cases. Spasticity is a type of hypertonia that clinically manifests as dynamic contractures. The dynamic contracture along with the reduced level of physical activity in a child with CP leads to secondary structural and morphological changes in spastic muscle, causing real musculotendinous shortening, known as fixed contractures. When fixed muscle contractures are not treated early, progressive musculoskeletal deformities develop. As a consequence, spastic CP from a static neurological pathology becomes a progressive orthopaedic pathology which needs to be managed surgically. Orthopaedic surgical management of CP has evolved from previous "multi-event single level" procedures to a "single event multilevel" procedures, with changes in selection and execution of treatment modalities. There is increasing evidence that multilevel surgery is an integral and essential part of therapeutic management of spastic CP, but more research is needed to ensure effectiveness of this intervention on all domains of physical disability in CP.
Keywords: Cerebral palsy; Musculoskeletal problems; Orthopaedic surgery.
© 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.
Conflict of interest statement
None.
References
-
- Bache C.E., Selber P., Graham H.K. (ii) the management of spastic diplegia. Curr Orthop. 2003;17(2):88–104. doi: 10.1054/cuor.2003.0328. - DOI
-
- Hutchinson R., Graham H.K. Management of spasticity in children. In: Barnes M.P., Johnson G.R., editors. Upper Motor Neurone Syndrome and Spasticity: Clinical Management and Neurophysiology. second ed. Cambridge University Press; USA: 2008. pp. 214–239.
Publication types
LinkOut - more resources
Full Text Sources
Research Materials
Miscellaneous