For many years, the treatment of orthopaedic problems in cerebral palsy has been somewhat neglected. The pathology was poorly understood and therapy was based mainly on muscle releases in contractures or spastic muscles aiming at muscle balancing. The overall outcome was better than the natural history but deformities still developed—and develop today—and function was improved in a more static, less dynamic way: the legs were stable in stance but too rigid to bend. Bony surgery, for a long time, was regarded as inadequate and too much for the often poorly nourished patients. Muscle strengthening was thought to increase spasticity. It took a while to realise the importance of weakness, and sensory disorder has only been part of the cerebral palsy definition for a few years. Gait analysis, on the other hand, has increased the understanding of normal and pathological function. All these more recent findings changed the treatment and improved the outcome of patients with cerebral palsy of all functional levels. Due to this success, the treatment of orthopaedic problems in cerebral palsy has gained increasing interest.

In 2011, I had the honour of organising a pre-course meeting on the current aspects of treatment in cerebral palsy. Thanks to the excellent speakers, it was very successful, and it was decided to use the content of the presentations to form a regular issue of the Journal of Children’s Orthopaedics (JCOR), which covers the present and modern concepts in these respects. It is a special pleasure that highly reputed authors from various countries contributed to this issue, which, therefore, provides a good overview on the current opinion of treating problems of the locomotor system in patients with cerebral palsy, of ambulators and of non-ambulators. As the authors describe their current practice and concepts in the first line, in front of the necessary literature and research, the JCOR issue has the character of an instructional course summary. Its special value is the collaboration of authors from different centres, co-operating for a compound overview, although not all aspects could be addressed. I thank all the authors for their work.

R. Brunner.