The surgical treatment of cerebral palsy

Surgical management of cerebral palsy is a useful adjunct to physiotherapy and orthoses. Accurate management depends upon evaluation of the type of motor disorder present and a quantified assessment of function. The timing of surgery is dictated by growth and biology. Measures to manage spasticity need to be implemented before excessive deformity occurs whilst soft tissue deformity management is best deferred until there is less growth remaining. Excessive deformity in the middle years of childhood may require bony surgery to improve comfort, stability or function. Because of the complexity of the condition and the intimate relationship with growth, management has to be multidisciplinary and take a long-term view with the objective of the best functional and symptomatic outcome at skeletal maturity.