Management of Upper Extremity Manifestations of Cerebral Palsy

Abstract

This current concept review serves as an introduction and basis for the evaluation and treatment of upper extremity dysfunction in cerebral palsy. It provides a background on the management of the upper extremity manifestations of cerebral palsy following a 2021 lower extremity tutorial in JPOSNA® on the treatment of gait abnormalities in cerebral palsy. In this review, we will discuss one approach to the classification, assessment, and current management modalities, nonoperative and operative. In successive editions of JPOSNA®, we will present panel discussions of patients with classic presentations and their treatment. Our hope is that upper extremity care will be a parallel consideration for all patients with cerebral palsy. Key Concepts: • The upper extremity assessment and management should occur in parallel to lower extremity care in patients with cerebral palsy. • Many patients with cerebral palsy upper extremity involvement will not require surgical care. • The use of standardized assessments and careful assessment over time will guide treatment. • Surgery at one level in the arm will affect the joints distal, particularly for muscles that cross two or more joints. The overall balance must be considered.