Orthopedic surgery is surgery performed on bones, muscles and joints.

Orthopedic surgery is performed both in the lower extremity (feet, legs and hips) and the upper extremity (hand, forearm and elbow) for patients with cerebral palsy. This portion of the site will focus on upper extremity (UE) surgery for patients with cerebral palsy (CP).

Since there are no tested ways that medicine knows of to operate on the brain to make cerebral palsy (CP) better, orthopedic surgery can help to “rebalance” muscles that are getting inappropriate signals from the brain.

Two common problems in cerebral palsy are muscles “over-working” and muscles “under-working”. Over working would include increased tone or spasticity. Spastic or high tone muscles can be weakened by surgically sectioning (cut) some of the fibers so they cannot pull as strongly. Under working would include flaccidity, weakness or low tone. Some muscles under work so much that they do not fire at all. Finding a less needed muscle that is working well and moving a part of that working muscle to the weak area can help important muscles that are weak.

In short answer, anyone with muscle problems caused by cerebral palsy (CP) can be appropriate for surgery. You need an evaluation by an experienced team in order to assess your specific situation.

For patients with cerebral palsy (CP), the best age for surgery is about 6 years old. At 6 year of age, many children can follow simple directions but are still developing new skills so they can integrate their new muscle patterns very well. Some children benefit from waiting until they are a little older. As an adult, surgery is still indicated, just more of the rehab will focus on retraining the muscle. A child will pick things up more spontaneously.

Most types of patient with cerebral palsy (CP) can benefit from orthopedic surgery. Goals of surgery can range from improving a dependent patients hand position in order to make dressing easier for caretaker to changing mild muscle tightness in independent patients.