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Surgery of the upper extremity in cerebral palsy
L Andrew Koman1, Thomas Sarlikiotis, Beth P Smith
1Department of Orthopedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. lakoman@wfubmc.edu
Insights
Surgical interventions can improve upper extremity function in children with cerebral palsy (CP). This review details surgical reconstruction, evaluation, and care for CP-affected limbs.
Area of Science:
- Orthopedic surgery
- Pediatric rehabilitation
- Neuromuscular disorders
Background:
- Cerebral palsy (CP) frequently causes upper extremity functional limitations.
- Surgical treatment is underutilized, with less than 20% of affected pediatric patients undergoing intervention.
- Reconstructive surgery offers a potential pathway to improved limb function.
Purpose of the Study:
- To provide a comprehensive overview of surgical interventions for upper limb reconstruction in pediatric CP.
- To guide optimal surgical approaches based on specific deformity types.
- To outline essential evaluation techniques, operative planning, and postoperative care.
Main Methods:
- Review of current surgical techniques for upper extremity reconstruction in cerebral palsy.
- Description of deformity-specific surgical strategies.
- Presentation of pre-operative evaluation and post-operative management protocols.
Main Results:
- Detailed descriptions of various surgical procedures tailored to specific upper limb deformities in CP.
- Emphasis on individualized treatment planning based on comprehensive patient assessment.
- Guidelines for effective post-operative rehabilitation and care to maximize functional outcomes.
Conclusions:
- Surgical reconstruction is a viable option for improving upper extremity function in children with CP.
- A systematic approach encompassing thorough evaluation, tailored surgical intervention, and diligent postoperative care is crucial.
- Optimizing surgical timing and technique can significantly enhance functional outcomes and quality of life for these patients.
Abstract:
Functional activities of the upper extremity are limited in most individuals with a diagnosis of cerebral palsy (CP). However, surgical interventions are applied in less than 20% of pediatric patients with an upper extremity affected by CP. This article covers the surgical interventions used for the reconstruction of the upper limb in patients with CP. The optimal surgical approach for each deformity type is described. In addition, the various evaluation techniques of the upper extremity, the general principles of an operative treatment plan, and the appropriate postoperative care of these patients is presented.
