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

It is also possible to be examined at an orthopedic clinic alone as part of the outpatient clinics.

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.

Cerebral Palsy (CP)

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).