TOTBİD Dergisi

TOTBİD Dergisi

2018, Cilt 17, Sayı, 5     (Sayfalar: 427-436)

Orthopedic treatment of spasticity in cerebral palsy

Murat Celal Sözbilen 1, Emre Çullu 2

1 Dr. Behçet Uz Çocuk Hastalıkları ve Cerrahisi Eğitim Araştırma Hastanesi, Ortopedi Kliniği, İzmir
2 Adnan Menderes Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, Aydın

DOI: 10.14292/totbid.dergisi.2018.56
Görüntüleme: 225
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İndirme : 162

Cerebral palsy is one of the most common causes of neurological disability encountered in childhood. Today, with the prenatal and perinatal care being gradually improved, risky pregnancies can be followed closely. At the same time, with the development of newborn intensive care units, premature and low birth weight infants can survive. For this reason, the incidence of cerebral palsy has increased up to levels of 2–2.5 in 1000 live births over the recent years. In this case, early and accurate diagnosis of these children will increase the success of spasticity treatment. Spastic type is the most common type encountered among cerebral palsy subtypes (80%). As the main pathology in spasticity is the central nervous system, what can be achieved orthopedically is the treatment of spasticity in the musculoskeletal system. Orthopedically, what is attempted to achieve should be the optimization of quality of life and movement of the child with cerebral palsy. For this purpose, this disorder should be evaluated very well on patient basis, and orthopedic treatment should be determined as multidisciplinary treatment with physical therapy and pediatric neurology. In this sense, spasticity treatment starting at early childhood includes a broad range of treatments (botulinum toxin A applications, physical therapy) that can, in the future, be extended into soft tissue lengthening, and bone surgery. The goal should not be to solve problems one by one, but to fix the overall functions as general as possible, and to prevent permanent deformities. Spasticity requires a long-term treatment and functionability of the patient, and the treatment should attempt to improve the functions step by step.

Anahtar Kelimeler : cerebral palsy; spastisity; botulinum toxin A