Cause of shortening in hemiplegic spastic cerebral palsy- Osseous development is extremely sensitive to the influences of its immediate environment. Carter et al. (Clin Orthop 1987;219:237–50 ) showed that mechanical stress is integral to the developmental biology of bones. In addition, local Vascularity, nutritional status, and hormones all affect bone growth. In vivo, enchondral ossification is inhibited by high compressive- dilatational forces and accelerated by intermittent shear stresses.
In the absence of mechanical stresses, Skeletal morphogenesis fails to progress. Bone formation and growth are products of the biomechanical demand placed across the growing bone. So it is very important to manage hemiplegic CP at early age to prevent l limb shortening. Management protocol can be regular therapy (stretching, strengthening, CIMT), proper bracing, botulinum toxin and surgical…
