Patients with cerebral palsy may develop upper extremity contractures and deformities due to imbalances in muscle tone, leading to limitations in function. Upper extremity reconstructive surgery can correct deformity and rebalance the muscles to increase functional use and improve hygiene and cosmesis. This course will provide an overview of the pre-operative evaluation, surgical planning and treatment, and post-operative therapy of the upper extremity in cerebral palsy. Through an interdisciplinary approach, the evaluation of the child with cerebral palsy will first be discussed including important points in the history and physical examination. Pre-operative evaluation including videotaping will be reviewed along with the use of Botox. A scheme for an operative plan will be developed with goals, guidelines, and options for surgical intervention.

A discussion of surgical and non-surgical treatment options for upper extremity will be presented for:

• Shoulder deformity
• Elbow flexion
• Forearm pronation
• Wrist flexion
• Digital flexion & swan-neck deformity
• Thumb-in-palm deformity
• Post-surgical therapy will be reviewed including splinting, therapeutic exercises and activities, precautions based on surgical procedures performed, and constant induced therapy

Upon completion of this course, participants will feel comfortable evaluating and treating upper extremities in cerebral palsy.