[The spastic hand. Postoperative rehabilitation]

Postoperative rehabilitation starts with preoperative evaluation of the patient. The outcome of rehabilitation measures is strongly dependent on the surgeon's ability to define a realistic rehabilitation aim, i.e., a goal the patient can achieve with a high degree of probability. Therefore, knowledge of the patient's individual basic situation and status as well as of the autonomic development of the different categories of cerebral palsy is of great importance. The operative procedures used are well established in cerebral palsy surgery. They are accepted as standard procedures. The decisive question is to whom they are offered. The same conditions pertain to the postoperative rehabilitation period. During that time a combination of functional bracing and physiotherapy plus occupational therapy is offered after primary cast immobilization. This period is finished when the specific aim has been achieved, i.e., integration of the gained function into everyday life.