The Neuro-Orthopaedic Approach

Matthew T Winterton; Keith Baldwin

doi:10.1016/j.pmr.2018.04.007

The Neuro-Orthopaedic Approach

Phys Med Rehabil Clin N Am. 2018 Aug;29(3):567-591. doi: 10.1016/j.pmr.2018.04.007. Epub 2018 May 29.

Authors

Matthew T Winterton¹, Keith Baldwin²

Affiliations

¹ Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, 3737 Market Street, 6th Floor, Philadelphia, PA 19104, USA.
² Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, University of Pennsylvania, 2 Wood Center, 34th and Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address: Neurorthopod@gmail.com.

PMID: 30626516
DOI: 10.1016/j.pmr.2018.04.007

Abstract

Upper motor neuron disease or injury can lead to muscle spasticity or nonfunction throughout the body. Imbalance in muscle forces predisposes patients to development of functional deficiencies, contractures, pain, and poor hygiene. The approach to neuro-orthopaedic patients is by necessity multidisciplinary, because a variety of nonsurgical and surgical options are available. In evaluating each patient, surgeons must consider the extent and quality of any deformity, potential for improvement in function, the ability to alleviate pain, and potential for improvement in hygiene and cosmesis. Surgical techniques include tendon lengthenings, releases, transfers, osteotomies, and bony fusions.

Keywords: Contracture; Deformity; Neuro-orthopaedics; Spasticity; Upper motor neuron disease.

Publication types

Review

MeSH terms

Humans
Motor Neuron Disease / complications
Motor Neuron Disease / diagnosis
Motor Neuron Disease / surgery*
Muscle Spasticity / complications
Muscle Spasticity / diagnosis
Muscle Spasticity / surgery
Orthopedic Procedures* / methods