Neurológia pre prax 4/2011

The current approach to the orthopedic surgical treatment of patients with cerebral palsy

The author presents indications and contraindications of orthopaedic surgery in children and adolescents with cerebral palsy, taking into account the types of cerebral palsy and the level of developmental Vojta stage. Surgical approaches include isolated and combinad procedures on muscles and bones. The ankle, knee and hip should be treated as one functional unit. Surgical approaches in the hip area include isolated and combined surgeries on muscles and bones (adductors and flexors, open reposition, proximal femoral osteotomy, acetabuloplasty). The area of the knee involves a knee flexion deformity and high position of the patela. The main operation in this area is hamstring lengthening. In the area of the foot muscle procedures on triceps surae and operation to stabilize the foot are indicated. There is presents therapeutic principles for procedures in the area of spine and upper extremities in patients with cerebral palsy.

Keywords: tenotomy, tendon prolongation, osteotomy, arthrodesis.