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Spasiticity surgery is performed to maximise the functionality of the arm and hand whilst minimising pain.
Spasticity of the arm and hand can lead to a vicious cycle of pain, stiffness and loss of use. Carefully planned and timed surgery can break this cycle by rebalancing the limb, particularly if carried out in childhood.
This surgery is specialist and is offered in only few centres worldwide.
The main benefit of surgery is to restore or maximise function in the arm and hand to allow patients to use the hand.
Other benefits include relief of painful spasticity and easier care, e.g. dressing, cleaning a clenched hand.
There are a range of operations that all aim to re-balance the arm and hand. The commonest procedures are to correct a tight elbow or flexed wrist or to allow the thumb to move out of the palm. Other procedures are aimed at improving grasp and release.
Procedures are often carried out in combination. Typically patients are in hospital for one night and are followed up regularly by a team consisting of the surgeon, the physiotherapist and occupational therapist in the specialist clinic.
Local therapists are involved from the start and we liaise with all the health professionals involved with our patients' care locally.
The general complications of any operation (bleeding, wound infection, poor scarring, and damage to important structures) are uncommon in this group. Some expected effects of surgery do occur however and these require good aftercare to maximise healing and recovery. These include post-operative swelling and stiffness. Our team of therapists works with all our patients to minimise these.
Recovery times for healing are typically 2-4 weeks. There is however a programme of aftercare exercises and scar care that continues for 6-12 months (depending on the severity of the initial problem) that is taught to patients and their carers.
Surgery for cerebral palsy of the hand and arm is a treatment programme consisting of operations and aiming to allow patients to get maximum use of their hands and to reduce disability.
Author: Mr Waseem Saeed FRCS(Plast), Consultant Plastic, Reconstructive and Hand Surgeon at The Alexandra Hospital.