Orthopaedic management of children with myelomeningocele: a plea for realistic goals.

The aims and principles of orthopaedic management of children with a myelomeningocele are discussed. The primary aim is to establish stable posture, and details are given of the various operative procedures used to bring about stable posture. The management described has resulted in reductions in the number of operations for each child, in the incidence of post-immobilisation fractures, in the number of hospital admissions and in the number of bed-days spent in hospital.