Overview of Cerebral Palsy
Children with cerebral palsy undeniably suffer from a range of physical disability. Some can either be mildly impaired while others, severely affected by the condition. The severity of the condition depends on the damage done to the brain. Brain damage in children can be limited; here it affects the part of the brain that coordinates movement especially walking. In other instances, it can affect the entire body muscle control nervous system. Severe cases of this condition may distort a baby's posture. The child's body may either be stiff or very floppy. Additional medical conditions caused by cerebral palsy may also include loss of control over body parts like the tongue and the mouth causing speech problems, drooling and difficulty in eating (Rethlefsen 80). Cerebral palsy has no cure, but its effects are often mitigated through drug therapy, non-drug therapy and also surgery. The following paper will explore the merits and demerits of using Orthopedic Surgery as a means to correct deformities caused by cerebral palsy.
Behavioral and Social Challenges
Children that have cerebral palsy develop behavioral problems and tend to suffer from social problems. The social problems arise when the child is experiencing difficulty in communication. Speech impairment makes the child to shy away from social interaction. The inability to be understood adversely affects the child's intellectual development especially if the people around the child do not take time to comprehend his or her attempts to communicate verbally. In most cases, the child becomes socially inhibited because of the communication barrier (Rethlefsen 82). Socializing and communication is a constant need in child development, and when a child is incapable of conveying information at ease, then emotions get in the way of communication. They are continuously faced with the prospect of not being accepted by their peers. Some of them may feel left out, and the will want to fit in. Therefore, they get very self-conscious.
Managing Cerebral Palsy
It is a fact that meeting the needs of a child with cerebral palsy is not an easy task as the condition is not curable. However, as much as the condition is not correctable, it can be managed by minimizing deformities to maximize the child's abilities (Rethlefsen 86). The specific treatments are based on the child's age, type of cerebral palsy, the child's reaction to particular medication or therapies, and the extent of the disease. The child may be put on medication that will relieve muscle tightness to enhance functional abilities and treat the pain. Such medication will help the child cope as it will manage complication related to muscle stiffness and deal with all the other arising symptoms. If the doctor does not recommend medication as the form of treatment, then he might use a variety of nondrug therapies to help in the development of the child's motor skills and enhance mobility. Examples of non-drug therapies include speech therapy, physical therapy, occupational therapy and recreational therapy.
Orthopedic Surgery for Cerebral Palsy
Surgery is so far the most effective treatment for children with cerebral palsy especially when they are old enough. Brain damage caused by cerebral palsy affects the muscles and the child's ability to control them. Orthopedic surgery is a standard procedure among those who have cerebral palsy, especially on the hips, wrists, legs, shoulders or arms. Depending on the treatment goals, the operation may as well be performed on the nerves, muscles, tendons or bones (Miyanji 587). The common orthopedic conditions may include posture, balance, coordination of movement and control, oral motor function, fine motor function, irregular reflexes and muscle tone abnormality. This type of surgery is often performed on hips, legs, and ankles. However, the surgery does not have a set protocol since every condition is unique, and individuals vary.
Benefits of Orthopedic Surgery
Orthopedic surgery improves the functionality of both the upper and lower extremities. The operation ensures that impairments would be minimized and movement barriers would be eliminated as much as possible. The child's ambulation is improved, and use of extremities is made ideal with or without the adaptive equipment (Thomason 59). Pain as a result of the impairments such as contractures, subluxation of the hip, dystonia, and scoliosis is minimized. With certainty, the surgery optimizes self-care and independence (Thomason 61). Now that the child is in a stable condition, then he or she can be able to perform simple duties without necessarily relying on the caregiver. Behavioral problems will reduce because they are no longer in pain and there is an improvement in their functional capabilities. Dependency on caregivers as well as anxiety decreases especially when they are in social places.
Improvements and Risks of Orthopedic Surgery
Hip and spinal abnormalities that make body movement and mobility an issue are rectified, hence leading to an improved state of well-being. Movement is maximized as the gross motor skills are controlled, and they are functionally maintained. The child's coordination and balance especially the head and trunk are enhanced (Difazio 304). Posture and standing will no longer be a challenge. Fine motor is improved after the surgery so that the child does not experience difficulty in organizing and sequencing movement (Thomason 62).
Risks and Limitations of Orthopedic Surgery
All the facts about the benefits of orthopedic surgery are correct; however, the surgery can also have negative outcomes. Many people run into surgery as a solution without knowing the risks involved in undertaking the surgery. The possibility of causing sensory damage to the child's body when performing surgery especially on the upper extremities is very high. The child may stand to lose all functional abilities, and this includes movement, balance, and coordination. The caregiver might think that they are helping the child not knowing that they are solving one problem while creating another (Difazio 302). Expectation may not be met for the surgery may achieve minimal results. Results of the surgery can even go unnoticed requiring the child to go for more surgery in the future. The continuous operations would overwhelm the child as he or she will most definitely go through physical and emotional trauma. As there is no cure for cerebral palsy, expect temporary results from the surgery for it does not provide complete remission. The child will be denied the little freedom he had. Therefore, the surgery should be the last option after exhausting all available treatments.
Potential Complications of Orthopedic Surgery
If the surgery is performed without the right expertise, it will without any doubt worsen the condition. Irreversible damage will have been done as the child will lose even the previous ambulatory capacity. Other complications like gastrointestinal and cardio-respiratory problems may arise after the surgery. Wound infection and wound bleeding can also occur. Further, the surgery might trigger a recurrence of a previously successfully treated deformity (Rethlefsen 87). The perioperative complications might even lead to death especially if the child develops a fatal embolism which goes unnoticed.
Conclusion
In conclusion, doctors should weigh the benefits against the risks of the surgery since it can be a double-edged sword; it has the potential of significantly improving functionality or even making it worse. Caregivers should understand that not all deformities ought to be corrected by surgery. It is therefore advisable that surgery is considered as a last resort following proper consultation and planning. Considering all the risks involved it is not advisable for a child to go through the orthopedic surgery especially if the surgery is just meant to correct the child's appearance.
Works Cited
Difazio, Rachel L., et al. "Differences in health‐related quality of life and caregiver burden after hip and spine surgery in non‐ambulatory children with severe cerebral palsy." Developmental Medicine " Child Neurology 58.3 (2016): 298-305.
Miyanji, Firoz, et al. "Assessing the Risk-Benefit Ratio of Scoliosis Surgery in Cerebral Palsy: Surgery Is Worth It." JBJS 100.7 (2018): 556-563.
Rethlefsen, Susan A., et al. "Prevalence of specific gait abnormalities in children with cerebral palsy revisited: influence of age, prior surgery, and Gross Motor Function Classification System level." Developmental Medicine " Child Neurology 59.1 (2017): 79-88.
Thomason, Pam. "Functional mobility and self‐care outcomes after multilevel orthopedic surgery in children with cerebral palsy." Developmental Medicine " Child Neurology (2018).
