Orientation d’une équipe adultes

The management of lower-limb deformities in walking cerebral palsy patients evolves with the patient as they move into adulthood. The patient becomes the only actor in the medical decision, and his or her needs evolve to become more functional and aesthetic. As the aim of surgery is no longer to prevent growth-related skeletal deformity, contractualization becomes essential. In adulthood, surgery mainly concerns the recurrence of deformities treated in childhood, secondary to increased spasticity or joint degeneration. Diagnostic and therapeutic management is based on a "step-by-step" approach, using motor blocks and good coordination between the surgical and PRM teams. Moreover, the morbidity associated with multisite surgery and the duration of post-operative rehabilitation make it less acceptable for the patient. The introduction of a child-adult transition consultation seems essential for these patients, whose management is long and complex.