It is very difficult to predict complex individual systems, they are like weather systems; it is even more difficult to predict the reliability of intervention. Orthopaedic surgery addresses several different areas: gait abnormalities, correction of hip deformity, upper limb and scoliosis surgery. Short muscles cannot be lengthened but surgery can alter the length of the tendons, redirect the tendons and, in some cases, divide the tendons to remove an abnormal force. Bones can also be divided and realigned and unstable joints fused. Lengthening tendons reduces tension in the muscle in the short term. Performing surgical correction at an early stage runs the risk of recurrence throughout growth, with the potential for repeat surgery. Perioperative and postoperative care is critical in ensuring that the treated abnormalities do not re-occur due to pain, lack of therapy and poor provision of orthotics.