Evidence map›Paper›PMID 41079171›Full record

ArticleJournal of the Pediatric Orthopaedic Society of North America2025

Current Variation in the Postoperative Management of Patients With Cerebral Palsy Undergoing Lower Extremity Surgery: A Survey of Surgeon Practices.

Arianna Trionfo, Christina Herrero, Jason J Howard, M Wade Shrader

Abstract read
In one paragraph

Article in Journal of the Pediatric Orthopaedic Society of North America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Arianna TrionfoDepartment of Orthopaedic Surgery, Nemours Children's Health, Wilmington, DE, USA.
Christina HerreroDepartment of Orthopaedic Surgery, Nemours Children's Health, Wilmington, DE, USA.
Jason J HowardDepartment of Orthopaedic Surgery, Nemours Children's Health, Wilmington, DE, USA.
M Wade ShraderDepartment of Orthopaedic Surgery, Nemours Children's Health, Wilmington, DE, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Children with cerebral palsy (CP) often develop lower limb deformities requiring surgical management. However, optimal postoperative management strategies-including weight-bearing progression, immobilization, and rehabilitation protocols-remain unclear. The purpose of this study was to evaluate current postoperative practices following lower extremity surgery in youth with CP. Methods: A 42-question electronic survey was sent to 114 practicing orthopaedic surgeons in the American Academy for Cerebral Palsy and Developmental Medicine. Six questions regarding seven surgical procedures (pelvic osteotomy, proximal femoral osteotomy, tibial osteotomy, isolated soft-tissue procedures, foot osteotomies, and foot fusions) were presented. Surgeons were asked about weight bearing, immobilization, initiation of physical therapy, standardized protocols, evaluation for inpatient rehabilitation, and educational sessions. Consensus was defined as >75% agreement for a given response (based on Delphi methodology). Results: Sixty-five surgeons from North America responded (57% response rate), with predominantly neuromuscular practices. Consensus was reached on only four of 42 questions (9.5%). Regarding weight bearing, 87.7% of surgeons allowed immediate weight bearing after isolated soft-tissue procedures. For immobilization, cast use reached consensus only for distal lower extremity surgeries including tibial osteotomy (95%), foot osteotomy (98%), and foot fusion (100%). Concerning rehabilitation and planning, no consensus was reached for any item. Conclusions: There was substantial heterogeneity in postoperative practices for children with CP undergoing lower extremity surgery. Other than immediate weight bearing after soft-tissue procedures and casting after distal bony procedures, no clear consensus emerged for weight-bearing progression, immobilization method, or rehabilitation planning. This variability may influence functional outcomes and patient satisfaction. Future studies regarding postoperative practices are warranted. Key Concepts: (1)Postoperative management varies widely for cerebral palsy (CP) patients after lower extremity surgery.(2)Weight-bearing protocols vary: some allow early weight bearing, while others restrict for 8 weeks.(3)No standardized guidelines exist for rehab after lower extremity surgery in CP. Level of Evidence: IV.

Indexed as

Cerebral palsyLower extremity surgeryPostoperative carePractice patternsRehabilitationWeight bearing

Identifiers

PMID41079171
PMCPMC12513309

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.