Orthopedic surgery is used to treat tight muscles and spasticity
related to cerebral palsy. An incision is made in the skin over
the affected muscle. Parts of the muscle are then cut to release the
What To Expect After Surgery
After orthopedic surgery:
Joints that were previously stiff can move more
easily. However, the affected muscle may be weak.
Some people may
need to wear a cast or brace to support an area where movements are not under
Why It Is Done
The type of orthopedic surgery done to treat problems from cerebral
palsy depends on which muscle groups are affected. Some basic goals are to
Muscles that make the hips turn toward the body
(partial release of the hip adductor muscles). This surgery increases hip
movement, allowing a child to sit and walk more easily. It also may be done to help prevent hip dislocation in children who are at risk.
the back of the thigh (partial hamstring release). These muscles control the
tension in the thigh and around the knee, allowing a child to sit and walk with
a more normal posture.
Tendon at the back of the ankle (Achilles
tendon lengthening or heel cord lengthening). This surgery helps a child walk
with a flatter foot.
Orthopedic surgery may be considered when a child with CP
A bone or joint deformity that causes pain or
interferes with function and is getting worse over time.
A spinal deformity that is not improving with
A deformity that makes some caregiving functions,
such as bathing, extremely difficult or impossible.
How Well It Works
Corrections made during orthopedic surgery may be temporary. As a
person grows, the same muscles or other muscles may become tight and cause
contractures. Additional surgery may be needed.
Surgery of any kind carries the risk of bleeding, infection, or
need for repeated surgery. Orthopedic surgery carries the additional risk that
it may resolve some problems only to create more as a child grows and develops.
What To Think About
Doctors do not agree about the best age for children with CP to have surgery. Surgery may be postponed until a child is older than age 2. At that time, the doctor can try to release many tight muscles during the same surgery,
instead of releasing only one muscle at a time. Avoiding repeated surgeries has
many advantages, such as decreasing the number of times a child needs to go to
the hospital, decreasing overall time spent in physical therapy, and less
disruption of the child’s school and social life.
Before a child has orthopedic surgery, it is important to determine
whether he or she will be able to walk after the procedure. The goals for
children who will walk differ from the goals for children who will not walk.