[Current concepts for surgical treatment of cerebral movement disorders]

In cerebral palsy orthopedic surgery can avoid deformity, existing deformities can be corrected, muscle imbalance can balanced and painful conditions--such as early osteoarthritis in hip dislocation--can be diminished. A tremendous functional improvement is not to be expected. In order to achieve good results the correct diagnosis is important, the natural course of the disease must be known. A team approach that includes the pediatric neurologist, physical therapist and the orthopedic surgeon is a must. The goals of therapy have to be discussed with the patient and his/her parents. If possible electromyography and gait analysis should be done but exact clinical evaluation is most important. The interactions between different groups of muscles must be known. It is important to differentiate primary and secondary, dynamic and fixed deformities. Orthopedic surgery can make life easier for a person with cerebral palsy, but cerebral palsy itself can never be over come.