Spastic Hand - CHU Sainte-Justine - SAAC

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Goals & Expectations ‣ Discuss expectations with patient and caregivers • Will not achieve a “normal” limb ‣ Team approach • Therapists, physiatrists, pediatricians can all help determine the goals of surgery ‣ Usefulness of patient questionnaire
‣ Improving function is not the only objective of surgery ‣ Consider Three goals: • Improved function • Improved cosmesis • Improved hygiene
Page 1 and 2: Upper Extremity in Cerebral Palsy:
Page 3 and 4: ‣ Remember: • While the brain l
Page 5 and 6: ‣ “traditional criteria” for
Page 7 and 8: Voluntary Hand Use ‣ Very difficu
Page 9 and 10: Grading of Hand Function ‣ Green
Page 11 and 12: Sensibility ‣ Very difficult and
Page 13 and 14: Sensibility ‣ Improved functional
Page 15 and 16: Athetosis/Movement disorder ‣ Flu
Page 17: Timing ‣ Delay surgery until a cl
Page 23 and 24: Physical Examination Just a few tip
Page 25 and 26: Physical examination ‣ Often diff
Page 27 and 28: Spasticity ‣ Velocity dependent i
Page 29 and 30: Range of motion ‣ Assess both act
Page 31 and 32: Elbow ‣ Resting position - usuall
Page 33: Forearm ‣ Unable to oppose hands;
Page 36 and 37: ‣ Volkman’s angle Flexor tightn
Page 38 and 39: Grasp and Release ‣ Evaluate gras
Page 40 and 41: ‣ Curled or clenched into a fist
Page 42: Thumb ‣ Thumb-in-palm deformity 1
Page 45 and 46: Additional studies ‣ Motion labor

Spastic Hand - CHU Sainte-Justine - SAAC

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