{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:04:56Z","timestamp":1790064296510,"version":"4.0.1"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001230","name":"Macquarie University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001230","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To describe preoperative medical evaluation, optimisation and acute postoperative outcomes in children and adolescents with cerebral palsy (CP) undergoing lower limb orthopaedic surgery managed in a Combined Rehabilitation Orthopaedic Paediatric Service (CROPS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective medical record review of children and adolescents with CP managed in CROPS between 1 January 2019 and 1 June 2024. Inclusion criteria: patients were between 0 and 19\u2009years of age, had CP (Gross Motor Function Classification System IV or V) and had lower limb orthopaedic surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010three patients were included in the analysis. Median age at preoperative medical review was 8\u2009years 9\u2009months (range 2\u2009years 2\u2009months to 18\u2009years 3\u2009months, IQR 6\u2009years 5\u2009months). Twenty patients needed seizure management (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920\/42, 37.7%), eighteen needed feeding input (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918\/53, 34.0%), fourteen required respiratory optimisation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914\/53, 26.4%) and thirteen needed nutritional supplementation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913\/53, 24.5%) prior to surgery. There was only one intraoperative complication. Postoperatively, thirteen patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913\/53, 24.5%) required antibiotics for respiratory infections, nine (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099\/53, 17.0%) had feed intolerance, five (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200953, 9.4%) developed pressure injuries and one (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091\/53, 1.9%) developed a urinary tract infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There were minimal intraoperative complications, most occurring postoperatively, supporting the need for preoperative medical evaluation and shared care in the postoperative period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70571","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:28:28Z","timestamp":1789705708000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Medical Evaluation and Optimisation of Children and Adolescents With Cerebral Palsy (\n                    <scp>GMFCS IV<\/scp>\n                    and V) With Complex Medical Comorbidity Undergoing Lower Limb Orthopaedic Surgery: Results of a Combined Rehabilitation Orthopaedic Paediatric Service"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1461-1000","authenticated-orcid":false,"given":"Jennifer","family":"Armstrong","sequence":"first","affiliation":[{"name":"Department of Orthopaedics The Children\u2019s Hospital at Westmead  Sydney Australia"},{"name":"School of Health Sciences and Nursing, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4075-0733","authenticated-orcid":false,"given":"Emre","family":"Ilhan","sequence":"additional","affiliation":[{"name":"School of Health Sciences and Nursing, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5577-2732","authenticated-orcid":false,"given":"Verity","family":"Pacey","sequence":"additional","affiliation":[{"name":"School of Health Sciences and Nursing, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Bray","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Axt","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Children\u2019s Hospital at Westmead  Sydney Australia"},{"name":"Sydney Medical School, Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1398-7495","authenticated-orcid":false,"given":"Jacqueline","family":"Dalby\u2010Payne","sequence":"additional","affiliation":[{"name":"Department of General Medicine The Children\u2019s Hospital at Westmead  Sydney Australia"},{"name":"The Children\u2019s Hospital at Westmead Clinical School University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.82"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e31825eb2a6"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073811428378"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2015.30.4.489"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000404"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-4054-3"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jspd.2018.05.005"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2018.2.PEDS17724"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14359"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000027776"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e328339250b"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073808331084"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2006.00587.x"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0887-8994(96)00124-5"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15055"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_14_18_1","unstructured":"JASP Team JASP(Version 0.19.3) [Computer Software] 2024 https:\/\/jasp\u2010stats.org\/."},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2013.223"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70571","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.70571","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70571","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:15:38Z","timestamp":1790061338000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.70571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":18,"alternative-id":["10.1111\/jpc.70571"],"URL":"https:\/\/doi.org\/10.1111\/jpc.70571","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"assertion":[{"value":"2026-07-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jpc.70571"}}