Cerebral Palsy (CP)

Cerebral Palsy (CP)

ALYN has an integrated multi-disciplinary cerebral palsy clinic where the orthopedic examination is conducted by a pediatric orthopedists from Hadassah Hospital. (קישור לחלון של המרפאה באתר של אלי"ן)

It is also possible to be examined at an orthopedic clinic alone as part of the outpatient clinics, by the doctors from the department – Dr. Eylon or Dr. Frankl.

Hip Surveillance

Hip surveillance is of utmost importance for children with cerebral palsy. Changes in muscle tone caused by cerebral palsy may cause dislocation of the hip joint, which occurs gradually over the course of months or years. Complete dislocation of the hip may cause significant movement restriction, difficulty maintaining basic hygiene, and most importantly - serious pain. This is why stringent hip surveillance, per the guidelines of the Israeli Medical Association, is so important.

Keeping the hip in place requires abduction (moving the leg away from the midline of the body), so it’s important to use an abduction brace if it was recommended to you.

When hip dislocation is in its early stage, it’s necessary to intervene. This may be in the form of botulinum toxin injections, soft tissue release surgeries, and sometimes even osteotomies (surgeries requiring bone cutting and/or realignment).

Orthopedic Treatments for Cerebral Palsy

Botulinum Toxin Injections 

Surgical Therapies

Tendon (lengthening) release - When a muscle is spastic over time, it often becomes shorter, which prohibit it to achieve a functional mobility range. Sometimes, when the shortened muscle interferes with functioning, limits mobility, or causes problems in the ongoing care of the child, tendon release surgery is necessary.

When should the surgery be done? The decision is made according to a physical examination of the child during locomotion and when lying down. Sometimes a pelvic x-ray is performed before a decision is made.

What to expect after surgery After tendon lengthening surgery, the involved joints are usually immobilized in casts or special braces for 4-6 weeks, according to the area operated on. For the most part, standing with the casts is permitted from day one post-operation. However, intensive physiotherapy is generally unnecessary when the child has a cast on, and the main rehabilitation period starts as soon as the cast comes off.

The possible rehabilitation frameworks after tendon lengthening surgery are - the child’s regular educational setting, full hospitalization at ALYN, or physiotherapy reinforcement (either at ALYN or in a community setting).

We recommend scheduling a preparatory appointment several weeks before the operation so we can get to know you and the child, and plan a customized rehabilitation program with regards to what setting and treatments are best for you. You can schedule an appointment at +972-2-6494327.

 

You can schedule an appointment at +972-2-6494327 or Fax: +972-2-6494-800.

You are welcome to invite your regular therapists to join.

 

Surgeries to treat skeletal deformities caused by cerebral palsy (osteotomies)

In specific cases, high muscle tone combined with locomotion restrictions may cause bone and joint deformities. When these deformities cause a functional disorder, pain, or a problem in the ongoing treatment of the child, the deformity needs to be addressed. For the most part these are major surgeries that include cutting bones to change the limb structure, and realigning them using plates and screws.

When should the surgery be done? The decision is made according to the child’s complaints, a physical examination of the child during locomotion and when lying down, and x-rays.

What to expect after surgery Osteotomy surgery entails a prolonged rehabilitation of several months.

The form of mobility that is permitted right after surgery is determined according to the type of repair made. It’s not always possible to make an advance assessment whether standing will be permitted after surgery, and we will only be able to know the medical instructions after the operation.

Osteotomy is only a start. 

After the surgery we generally recommend full hospitalization in the rehabilitation department, at least until the pain has subsided, practicing breathing and transitions, and getting set up at home with the assistive equipment required for the recovery period. After a brief inpatient period, and according to the instructions given by the surgeon, we will be able to plan the duration of hospitalization and the best framework for you during the lengthy rehabilitation (full hospitalization, day hospital/partial hospitalization, your regular educational setting, and so forth).

We recommend scheduling a preparatory appointment several weeks before the operation so we can get to know you and the child, in order to better prepare for the anticipated rehabilitative treatment period and plan a customized rehabilitation program for you in advance.

You can schedule an appointment at +972-2-6494327 or Fax: +972-2-6494-800.

You are welcome to invite your regular therapists to join.

 

  • What should you bring to the examination at the clinic?

A breakdown of the planned surgery (letter from the orthopedic surgeon)

An up-to-date letter from the physiotherapist who regularly treats the child

All the braces and walking aids you have

CDs with X-ray images, if done during the last year in another medical framework

 

 

 

Ask us:
02-6494222
Your message was sent successfully