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What is orthopedic surgery?
Orthopedic surgery is a way to treat deformities of the spine, legs, and arms. The goal of the surgery is to get the best possible motor function for daily activities (sitting, standing, and walking), and to improve ease of care and comfort. There are two types of orthopedic surgery, soft tissue procedures and bony procedures.
Soft tissue procedures lengthen or transfer tendons in order to lessen contractures and balance the pull of muscles. This lengthening or transfer improves function, comfort, and ease of care. When soft tissue surgery is done early, together with physical therapy and bracing, bone surgery may not be needed. However, when a child’s limbs are not the same length or bone deformities remain, then bone procedures may be needed.
Bony procedures include controlling limb growth using staples or screws around the joint, stabilizing unstable joints, and fixing bones to straighten or correct deformities. Children with spasticity resulting in scoliosis (abnormal curving of the spine) may need to have their spines straightened with metal rods.
Orthopedic surgery may be used in combination with other spasticity treatments like oral or intrathecal Baclofen, Botox®, or selective dorsal rhizotomy.
What children benefit from orthopedic surgery?
Children with spasticity who have worsening contractures or deformities may benefit from orthopedic surgery.
What are the risks and limitations of orthopedic surgery?
As with any surgery, there is a risk of infection and bleeding. Your child receives general anesthesia medicine so he or she can sleep during the surgery, and there are potential risks with the anesthesia. Talk with your doctor about these risks. In addition, there is a risk that the tendons and bones may not heal properly or the hardware (staples, screws, or rods) may fail.
Limitations of orthopedic surgery include the fact that it does not treat spasticity, but instead is aimed at the effects of spasticity. Also, there is a chance that more deformities may happen as your child grows.
What happens after orthopedic surgery?
What happens after orthopedic surgery depends on which type of surgery is performed. For example, after tendons are lengthened in the ankles, your child may be allowed to walk in walking casts shortly afterward. However, if your child has a more extensive surgery, he may stay in the hospital for a few days and be unable to move for up to six weeks. Often, the hardware (staples, screws, or rods) must be removed once the bone is healed.