Prevent contractures
Prevent dislocations
Improve walking
Provide stable and painless sitting
Allow perineal care
Hip Dislocation
Adductor contractures
Flexion contractures
In-toeing
Windswept hips
Accepted that a dislocated hip in CP is painful
Foot
A little equinus is better than calcaneus
A little valgus is better than varus
A little varus is better than severe valgus
TA lengthening is most over used operation in CP
Knee
A little knee flexion is better than recurvatum
Problems
Tight hamstrings
Upper limb surgery is mainly in spastic hemiplegia
- many of the CP' s have sensory neglect for affected limbs
- won't use limb post surgery anyway
Surgical indications
- a reasonable level of IQ (>70)
- spastic not athetoid
- voluntary grasp and release
Decreased tone
- Polio
- Down's syndrome
- spina bifida
Increased tone
- cerbral palsy
- Parkinson's
- CVA
Rare
- case reports only
Acetabular dysplasia not uncommon in this group
Results