TOTBİD Dergisi

TOTBİD Dergisi

2021, Cilt 20, Sayı, 3     (Sayfalar: 322-336)

Current and new trends in orthopedic surgery in the treatment of cerebral palsy: Lower extremity

Cemil Yıldız 1

1 SBÜ Gülhane Tıp Fakültesi, Ortopedi ve Travmatoloji Ana Bilim Dalı, Ankara

DOI: 10.14292/totbid.dergisi.2021.54
Görüntüleme: 541
İndirme : 1821

Musculoskeletal deformities in the lower extremities caused by lever-arm dysfunction in cerebral palsy may present with different clinical pictures depending on the neurological pathology, treatment timing and procedure. In the surgery of children with cerebral palsy, it is the current approach to create a patient-specific treatment algorithm by making a multifaceted all-around evaluation with advanced analysis methods. A wide variety of orthopedic surgery options including reconstructive surgeries are currently in use. Preventive surgeries such as adductor tenotomy, psoas lengthening and iliopsoas tenotomy, muscle tendon lengthening or transfer operations such as hamstring lengthening, rectus femoris transfer, patellar tendon advancement, osteotomy procedures such as shortening, derotation and varisation of proximal femur, reconstructive surgery such as Dega pelvic osteotomy and total hip arthroplasty. However, treatment should be done with a `multimodal and holistic interdisciplinary approach` with other options such as orthotic applications and rehabilitation. Patient/family/surgeon satisfaction increases when lower extremity surgery is applied as part of a multimodal holistic treatment after creating a concept around a goal. It should not be forgotten that different clinical pictures will occur during the growth process of pediatric patients with cerebral palsy, and the `a la carte` method should be chosen according to the needs of each patient, remembering that there is no simple or mild cerebral palsy patient. Being perfect in diagnosis and treatment has become a necessity with the help of new developing technologies, which are no longer a luxury.

Anahtar Kelimeler : cerebral palsy; spastic; bone muscle disease; lower extremity; orthopedic management