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Cerebral Palsy / Spastic Hemiparesis

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As in other neurological problems of the hand or upper extremity of the child, there is often a nihilistic view of the benefits of treatment. With an adequate patient assessment, surgical and nonsurgical treatment can improve not only the function but the self-esteem, by enhancing the spatial position of the limb.

Some relevant points of this condition are:

  • Cerebral palsy is becoming more common in developed countries due to increased survival of premature infants.
  • It is defined by the presence of motion problems due to an injury in the immature brain. Sensitivity and cognitive abnormalities may be associated.
  • The upper extremity requires a multidisciplinary management led by an orthopedic surgeon and an occupational therapist.
  • Non-surgical treatments (occupational therapy, physiotherapy and botulinum toxin injection) are essential.
  • Due to the heterogeneity of patient involvement, a repeated assessment of the patient is important.
  • The upper extremity surgery in spastic hemiparesis, if indicated, is intended as a definitive treatment to increase function. Surgical treatment is indicated from 6-8 years old of age.
  • The upper extremity surgery in spastic tetraparesis is usually designed to facilitate patient care.
     
Obstetric brachial palsy
Brachial Plexus Birth Palsy: Definition and Mechanisms of Injury:
Risk of brachial plexus birth palsy. Necessary diagnostic tests.
BPBP treatment: physical therapy and surgery
Shoulder problems in children with BPBP
Prevention and Risk of IRCS and DGH
Diagnosis and Treatment of Shoulder Dysplasia
What doctor does my baby need?
Clinical experience of Dr Soldado
Malformations
Short or absent thumb: thumb hypoplasia
Deviated wrist: radial and ulnar clubhand
Short fingers: Brachydactyly, symbrachydactyly, amniotic band syndrome
Less fingers: cleft hand and ulnar clubhand
Extra fingers or thumb: Polydactyly
Glued fingers or syndactyly
Cerebral Palsy
Definition, overview and assessment of cerebral palsy
Upper extremity problems in children with spastic hemiparesis
Nonsurgical treatment of spastic hemiparesis
The upper extremity in cerebral palsy with spastic tetraparesis
Surgical treatment of spastic hemiparesis
Microsurgery
Pediatric vascular microsurgery: overview
Bone loss reconstruction I: Vascularized fibula transfer
Bone loss reconstruction II: Periosteum transfer of vascularized fibula
Bone recalcitrant nonunion or pseudoarthrosis
Bone revascularization (osteonecrosis, aseptic necrosis)
Joint reconstruction. Transfer of epiphysis and growth plate of the vascularized fibula
Reimplantation and revascularization
Functional muscle transfer (vascularized and innervated)
Skin loss coverage
Fractures/Injuries
Overview of fractures
Typical bone fractures in children
Treatment of fractures in children: overview
Classification and treatment of physeal fractures
Fractures of the shoulder girdle, shoulder and arm of the child
Elbow fractures of the child
Fractures of the forearm and wrist of the child
Hand fractures in children
Upper extremity injuries of the child
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