Chirurgie du membre supérieur de l'enfant IMC

Not many spastic patients are candidates for surgery of their upper limb, because of the many other neurologic problems frequently associated. But several surgical procedures are available, aiming at reducing spasticity, correcting muscle contracture, and augmenting paralysed or weak muscles. The main goal is to improve function, but these surgeries may also be indicated to relieve pain, correct orthopedic deformities, facilitate nursing, or improve cosmesis. Surgery should be decided upon only after several sessions of evaluation of the upper limb, with all involved care givers, including clinical examination, video recording, and most of the time botulinum toxin. Family involvement and postoperative care (physiotherapy, splinting) are essential to the success of these interventions. When functional surgery is considered, it should be undertaken early, before the pathologic motor schemes are fixed.