Lower-extremity surgery for children with cerebral palsy: physical therapy management.

The purpose of this article is to discuss physical therapy for children with cerebral palsy who undergo orthopedic surgery. Children with spasticity (increased tone) often undergo surgical procedures to increase the length of the hip, knee, and ankle musculature in an attempt to improve musculoskeletal alignment and functional abilities. Presurgical assessment of posture and movement to determine potential for change in function and postsurgical management are discussed. Intervention immediately following soft tissue surgery at the hips and knees and intervention at the time of cast removal for those children immobilized in a hip spica cast are reviewed. Specific postsurgical management protocols related to immobilization in splints/casts, positioning, and treatment activities are presented.