Presentation on theme: "Management of the Upper Limb in Children with Cerebral Palsy Prof P McArthur FRCS(Plast) PhD Consultant in Congenital Hand and Upper Limb Surgery Department."— Presentation transcript:
Management of the Upper Limb in Children with Cerebral Palsy Prof P McArthur FRCS(Plast) PhD Consultant in Congenital Hand and Upper Limb Surgery Department of Plastic Surgery Royal Liverpool Children's Hospital Alder Hey Liverpool
Technique Sonography guided injection of Botulinum toxin Multilevel, multisite Dose range per child used 4 to 20 units/Kg
Visualization of muscle groups ?
Visualization of muscle groups PL FCR PT
The Multidisciplinary Team The Family and Child Hospital Physiotherapist Hospital Occupational Therapists Consultant Paediatric Neurologist Consultant Upper Limb Surgeon Consultant Lower Limb Surgeon Community Physiotherapists Community Occupational Therapists Specialist Children's Hospital
Summary Ultrasound guided treatment allows precise disposition of toxin to desired site Botox is the preparation of choice A multi disciplinary approach is required to maximize gains High level supporting evidence is elusive Individual goals for each child should be identified
Indications Pain Failure of Toxin Therapy Established Contractures Hygiene / Dressing / Transfer