Surgery Overview

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
tightness.

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
    control.

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
loosen the:

  • 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.
  • Muscles on
    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
has:

  • A bone or joint deformity that causes pain or
    interferes with function and is getting worse over time.
  • Permanent
    stiff joints (contracture).
  • Dislocated or irregularly
    functioning joints.
  • A spinal deformity that is not improving with
    other treatment.
  • 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.

Risks

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.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

Credits

ByHealthwise Staff
Primary Medical Reviewer Susan C. Kim, MD – Pediatrics
Specialist Medical Reviewer Louis Pellegrino, MD – Developmental Pediatrics

Current as ofMay 4, 2017