Cerebral Palsy and Pediatric Orthopedics

Many of the deformities treated by pediatric orthopedic surgeon, such as clubfoot, scoliosis and limb length deformity, are caused by a family of neurological disorders the most prevalent of which is cerebral palsy. Cerebral palsy and the muscular dystrophies cause muscle imbalances that can result in deformities of the musculoskeletal system. Since pediatric orthopedic surgeons specialize in correcting malformed bones and joints of children, no matter their root causes, these practitioners offer great hope to parents of children with these deformities. The specialized bracing and surgical techniques of pediatric orthopedic doctors offer children with CP and other neurological disorders their greatest potential for optimizing function and mobility.

The initial brain damage that resulted in cerebral palsy can never be reversed. But the pediatric orthopedist is a critical part of an overall treatment plan designed to improve the quality of life of children with CP. Cerebral palsy is a complex disease and it’s manifestations are variable. Because of this there may not be one surgical treatment that is used for all children with cerebral palsy. Pediatric orthopedic surgeons such as those at Children’s Bone and Spine Surgery need to use surgical procedures tailored to your child’s signs and symptoms.

One of the most common pediatric orthopedic operations for children with CP involves the lengthening of muscles and tendons in the arms, legs or feet that are too tight or spastic. This procedure is found to be especially helpful for the child who cannot sit well, or who has problems standing and walking due to the typical contractures of the hip, thigh and ankle that present with CP. After surgery when combined with physical therapy, these patients usually will experience increased motion and control. Other techniques used by pediatric orthopedic surgeons to treat children with cerebral palsy include:

•    Serial casting
•    Botox injections
•    Functional bracing

Recently pediatric orthopedic surgeons have been using BOTOX (Botulinum-A toxin) to treat the symptoms of CP in children. The BOTOX is injected into specific muscles paralyzing them and reducing spasticity.  Results have been very encouraging in many patients.  

Children with cerebral palsy often present with scoliosis, hip dysplasia, limb length inequality and other deformities commonly treated by the pediatric orthopedic specialist. For the patients with cerebral palsy the pediatric orthopedic surgeon will employ all of the non-invasive and surgical techniques indicated for these conditions.

Understand that the pediatric orthopedic surgeon is just a part of a multidisciplinary team that can help a child with cerebral palsy achieve their maximum potential.   Other members of that team include Physical Therapies, Occupational Therapists, Orthotics (Brace Makers), Physiatrists (Rehab Doctors), Seating Specialists and Social Workers of which all make referrals to the Pediatric Orthopedic Surgeon.