Orthopedic Procedures
Orthopedic procedures
correct deformities of dysfunction caused by spasticity
- contractures
- crouch gait
- hip dislocation
- bone rotation
- foot deformities
Orthopedic procedures
do not reduce spasticity
- soft tissue releases
lengthen and weaken muscles
- adductor release, hamstrings,
achilles
Rhizotomy
and Intrathecal Baclofen Therapy have redefined the role for Orthopedics
- still required to treat
bone abnormalities
- still required to treat
fixed contractures
- still required to replace
hips into socket
Orthopedic
procedures can be reduced by early treatment of spasticity
- avoid fixed deformities
- avoid repeated soft
tissue releases
- prevent progression
of hip dislocation
- postop casting easier
- rhizotomy studies show
~50% of patients with rhizotomy will still require
orthopedic procedure
Multi-disciplinary
approach to spasticity
- first, reduce spasticity
- second, aggressive
PT/OT
- serial casting
- stretching
- strengthening
- third, orthopedic procedures
to correct fixed deformities
