Module 5: Surgical Management Options

Having heard from these 3 orthopaedic surgeons we encourage you to reflect on a scenario of a client that you have come across previously, or are currently working, with who has severe spasticity or spasticity related contracture causing significant functional / postural or comfort limitations impacting quality of life.

Now consider the following points:

• What spasticity management options had already been trialled and with what effect?
• If those prior options were not sufficiently effective in their outcome was a referral to an orthopaedic surgeon made and if not, would you in hindsight now consider that to be an appropriate avenue to explore?

If you were thinking to refer a client for a surgical opinion to assist in managing spasticity related concerns which of the following might you consider to be valid reasons for referral?

• Leg flexion posture so significant it is preventing safe seating in a wheelchair
• Extreme pain on weightbearing through a contracted and unstable foot and ankle limiting standing transfers
• Comfort for bed positioning in palliative stage of brain tumour management.
• Skin breakdown and poor hygiene associated with a non-functional hand with high levels of spasticity