ORTHOPAEDIC MANAGEMENT IN CEREBRAL PALSY: 25 YEARS OF ROMAN SCHOOL EXPERIENCE

Cerebral palsy (CP) is a pathology characterized by a non progres- sive lesion of the central nervous system during its development, which is followed by peripheral manifestation that worsen with time. The roman school of orthopaedic, since its origins, has focal- ized on paediatric pathologies; in 1984, from the daily collabora- tion of one of its members, Luigi Romanini, and the neurologist Giorgio Sabbadini, the monograph “Indication for cerebral palsy orthopaedic surgery” was born, expression of a new approach to CP. The collaboration between rehabilitators and orthopaedic was highlighted: surgery is just part of a more complex management and it is necessary only if conservative treatment is not sufficient to obtain improvement or to maintain previous achievements. Surgery becomes then function-oriented, preceding in proximo-distal direc- tion and on multiple levels. Furthermore, a classification of the lower limb spastic form based on two varieties split in phases was introduced: this is the basis for guidelines in order to uniform sur- gical treatments, at today, still a problem for those who approach CP. At last, the outcome of these 25 years of experience in orthopaedic CP management is analyzed.