Surgical management of the lower extremity in ambulatory children with cerebral palsy.
Despite the increasing popularity of nonorthopaedic treatment alternatives for children with cerebral palsy, bony and soft-tissue surgery remains a common component in the management of ambulatory patients. Multisite simultaneous tendon surgery provides improvement in gait by addressing hip, knee, and ankle contractures together. Careful preoperative physical examination is required; computerized gait analysis can be useful in confirming a plan for multiple tendon surgeries. Rotational osteotomies can improve transverse-plane malalignment. Shorter periods of immobilization and aggressive postoperative gait training and strengthening may optimize improvements in gait.
Karol
Lori A
LA
University of Texas Southwestern Medical School, and Staff Orthopaedist, Texas Scottish Rite Hospital for Children, Dallas, TX 75219, USA.
D002547:Cerebral Palsy / Q000601:surgery*; D002648:Child; D004863:Equinus Deformity / Q000601:surgery; D005531:Foot Deformities, Acquired / Q000145:classification / Q000209:etiology / Q000601:surgery*; D005684:Gait; D006616:Hip Contracture / Q000209:etiology / Q000601:surgery; D006801:Humans; D007866:Leg / Q000601:surgery*; D009128:Muscle Spasticity / Q000209:etiology / Q000601:surgery; D011182:Postoperative Care; D011300:Preoperative Care