Cerebral Palsy by F Miller

By F Miller

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She had two additional medical treatments, one at age 10 years for additional muscle lengthening, and one at age 13, which consisted of a triple arthrodesis of her feet, hamstring lengthenings distally, and a rectus transfer at the knee. She continued to walk in the community with a combination of Lofstrand crutches and a walker. Around the house, she would walk holding on to furniture. During her high school years, she developed a mildly increased crouching gait pattern and was placed in a ground reaction ankle foot orthosis (AFO), which she disliked.

With aggressive medical treatment, the infection can be eradicated, and approximately 30% of children are left with CP and mental retardation. 1 In our experience, most of these children who survive bacterial meningitis and have CP will have very severe spastic quadriplegic pattern involvement. Temporary neurologic deficits are caused by many toxic agents, with alcohol being the most commonly encountered. Alcohol almost never causes a static neurologic deficit. Also, children with prolonged anoxic events, such as near drowning, near hanging, or near asphyxia, can make remarkable recoveries.

The judgment of recognizing a complication is one of the most difficult to develop and some physicians may never do it well. Many complications, especially in orthopaedics, do not present with the drama of a cardiac arrest. In orthopaedics, a more typical example is the presentation of a deep wound infection. Every wound with a little erythema and a mild superficial drainage is not a deep wound infection. However, when a deep wound infection is present, it should be acknowledged as such. 3). For this process to work, physicians first have to acknowledge the complication to themselves.

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