Pediatrics: Cerebral Palsy: Orthopedic Management

Question 1

Tendon Lengthening Procedures

Answer 1

• Correct moderate to severe deformities

- Typically used when the patient does not respond to pharmacological treatment

Question 2

Tendon Lengthening Procedures: Tendons most often lengthened

Answer 2

• Achilles
• Hamstrings
• Iliopsoas
• Hip adductors

Question 3

Tendon Lengthening Procedures: Effects

Answer 3

• Decreased contractility of muscle

Question 4

Muscle Transfers

Answer 4

• Muscle attachments moved to change direction of force

Question 5

Muscle Transfers: Most often transferred

Answer 5

• Hip adductors to hib abductors

Question 6

Osteotomies

Answer 6

• Cutting, removing, or repositioning bone to facilitate normal alignment, prevent subluxation/dislocation

Question 7

Osteotomies: Most often performed

Answer 7

Lower extremities

• Femoral
• Tibial
• Pelvic

Question 8

Orthopedic Management: Pros

Answer 8

• Decrease Contracture
• Decrease abnormal bony alignment
• Improve motor control
• Effects last a few years or more

Question 9

Orthopedic Management: Cons

Answer 9

• Anesthesia
• Non-weight bearing after bony procedures for severe weeks
• Risk of weakness and decreased function