FAJARDO, P.R. — A “multiple simultaneous procedures” approach to surgical management of upper limb cerebral palsy improves function and lessens deformity, Bruce R. Johnstone, M.D., said at the annual meeting of the American Association for Hand Surgery.
The technique involves the release, lengthening, or paralysis of deforming spastic muscles, as well as tendon transfers and joint stabilizations.
It is used to help improve the patient's appearance and the patient's ability to perform tasks of daily living such as dressing and proper hygiene, said Dr. Johnstone of Royal Children's Hospital, Melbourne (Australia).
A phone survey of 48 patients (or their caretakers) who had the surgery between 1992 and 2001 for upper limb spasticity showed that 41 (85%) were satisfied with the outcomes and felt the surgery was worthwhile.
Based on the 0–8 point House scale, median function level increased significantly from 2 points before the surgery to 4 points after the surgery.
Based on a 0- to 4-point cosmesis scale that was created for the study, cosmesis increased significantly from a median of 1 point to 3 points.
Scores for patient hygiene and the ability to dress oneself also increased significantly, Dr. Johnstone said.
The findings may be useful in counseling patients and their caretakers about potential outcomes following surgery, he added.