At our centre we treat a lot of patients with upper limb spasticity, mainly children diagnosed with cerebral palsy. Initially, children with upper limb spasticity are treated with physiotherapy and splinting. We frequently use sonographically guided Botox (Dysport) injections in order to improve spasticity and allow the physiotherapist and occupational therapist to work. In carefully selected cases our surgeon performs surgery in terms of soft tissue releases, tendon transfers and osteotomies in order to improve spasticity and function.