Surgical Treatment

Are we doing the right thing?

What should we do next?

A European Register

Motor Cortex Joint movement

Motor pathways

Basal gangliaSpinal cord Peripheral

nerveNeuromuscular junction

Muscle

Motor Cortex Joint contracture

Motor pathways

Basal gangliaSpinal cord Peripheral

nerveNeuromuscular junction

Muscle

Damage

Motor Cortex Joint contracture

Motor pathways

Basal gangliaSpinal cord Peripheral

nerveNeuromuscular junction

Muscle

DamageOrthopaedic Intervention

Preserving Strength

• Avoid surgical tendon and muscle lengthening

• Care with botulinum toxin

• ‘Dynamic’ use of orthoses

Preserving Strength

• Guided Growth

• Closed joint deformity correction

• Neurological manipulation

Motor Cortex Joint contracture

Motor pathways

Basal gangliaSpinal cord Peripheral

nerveNeuromuscular junction

Muscle

DamageOrthopaedic Intervention

Peripheral nerve Stimulation

Motor Cortex Joint contracture

Motor pathways

Basal gangliaSpinal cord Peripheral

nerveNeuromuscular junction

Muscle

DamageOrthopaedic Intervention

medication Peripheral nerve Stimulation

Standards

• Have a reason for an intervention

• See if it worked

• Record the result

• Let everyone else know

Cerebral Palsy Register