Pediatric orthopedic surgeons are trained in the evaluation and treatment of musculoskeletal (bone, joint, or muscle) problems in the growing child. While every child with cerebral palsy should have a pediatrician to take care of usual childhood illnesses and provide preventative care, a pediatric orthopedic surgeon is the primary physician that cares for musculoskeletal problems associated with cerebral palsy. One of the orthopedic surgeon’s roles is to monitor the growth and development of each patient’s bones, including the hips and spine.
A child’s bones continue to grow until skeletal maturity, which occurs some time after puberty. Spasticity, a common feature of cerebral palsy, typically causes muscle imbalance. These abnormal muscle forces can affect bone growth throughout childhood. Two the most often affected areas are the hips and spine. Routine clinical assessment and x-rays of the hips and spine are necessary to make sure the spine stays straight and that the hips are well developed and remain in the joint. Annual or semi-annual assessment allows timely early identification, prevention and treatment of hip dislocation and spinal deformity.
During a visit to the Center for Cerebral Palsy clinic, an assessment of the bones and joints of the body will be performed. Tightness of muscles, or limitations in range of motion, called contractures, may interfere with function and/or cause pain. The team will develop a treatment plan that may include casting, occupational or physical therapy, bracing, exercises or surgery. Sometimes, additional tests or procedures, such as a gait study or CT scan, may be needed to provide additional information for surgical treatment planning.