Cerebral Palsy Program at Cincinnati Children's.Children with cerebral palsy may need orthopaedic surgery to relax spastic muscles, repair joints, realign bones and relieve pain.

All children with CP should see an orthopaedic surgeon. Referrals can come directly from the family or from the child’s rehabilitation doctor, occupational therapist, physical therapist or primary care provider. Sometimes, a child’s first visit is for a straightforward concern, such as a foot that turns inward. Sometimes it is for more complex issues, such as difficulty walking because of weak muscles or tight tendons. Although we usually look to delay surgery in young children, early evaluation and assessment is critical.

An evaluation provides a detailed baseline assessment of your child’s abilities. The care team can use it to plan surgery now or down the road and track your child’s progress after treatment.

Your Child’s First Appointment

During your child’s first appointment, the orthopaedic surgeon will:

  • Provide a thorough physical exam
  • Observe your child playing and walking
  • Obtain and review needed X-rays
  • Ask your child to move in specific ways or do basic tasks
  • Evaluate the fit of your child’s assistive devices or wheelchair (if applicable)
  • Talk to you about your concerns, goals and expectations for treatment
  • Answer your questions

Hip and spine surveillance techniques help doctors monitor hip and spine problems that are common among children with cerebral palsy. By treating problems early, long before outward symptoms become apparent, the surgeon may be able to preserve the hip joint and avoid having to do major surgery later.

The doctor may order additional tests, such as more advanced imaging studies or functional assessments. If your child can walk, the surgeon may provide a referral for the Motion Analysis Lab at Cincinnati Children’s. All of this helps the orthopaedic surgeon understand the underlying causes of your child’s concerns, analyze what therapies could help and choose the least invasive option.

Once the test results are available, the orthopaedic surgeon will provide a personalized treatment plan that may include surgery, nonsurgical treatment or a combination of the two. Depending on the treatment plan, your child may return to see the orthopaedic surgeon for follow-up care.