Hamstring lengthening surgery is a medical process which is done to relieve pain and tightness in the hamstring muscles and to improve posture. This type of surgery is generally recommended for children who are suffering from cerebral palsy.
The hamstring lengthening procedure is usually performed in children with cerebral palsy. The muscle tone in these children is very high which results in the tightening of the hamstring muscles.
As the children grow, the muscles become permanently stiff, that is, they undergo contractures. The children who walk with bent knees are unable to straighten their knees while sitting, thereby assume a hunched posture.
The hamstring lengthening procedure is very useful for maintaining an upright posture while walking as well as allowing mobility in the knees, thereby averting a hunched posture while sitting.
Why is Hamstring Lengthening Surgery performed?
The hamstring lengthening surgery is performed to relieve lower limb contractures and to increase the ability of the knees to straighten out i.e. undergo extension. This helps the patient to:
- Improve gait
- Improve sitting and lying postures
What are the different tests Required Before Hamstring Lengthening Surgery?
Before the patient undergoes the procedure, the surgeon will carry out a thorough physical examination and check the range of motion of the lower limbs.
This will help the surgeon to recognize the degree of the problem and factors that could predict the outcome or the complications of the procedure.
For all patients who have to undergo an elective surgery (which is more planned), routine tests are required and include the following:
What happens at the time of Hamstring Lengthening Surgery?
An incision is made on the back of the thigh in the lower part. An incision below the buttock could be required if your child has a hunched posture while sitting.
Dissection is carried out to sequentially remove the semitendinosus, semimembranosus and biceps femoris hamstring muscles, using electrocautery or dissecting scissors.
These are then shortened by cutting the tendinous part of the muscle and allowing it to stretch out. This is the most common type of procedure.
Alternatively, a "Z" type of cut can be made, followed by sliding apart the ends of the muscles and suturing them in a lengthened position. The wound is then closed by suturing and covered with a dressing.
What are the Risks & Complications of Hamstring Lengthening Surgery?
As with all type of surgeries, hamstring lengthening surgery has the risk of bleeding. Moreover, complications arising from infections can also occur.
However, the surgery can treat abnormalities in gait and posture there might be a need for a repeated surgery in the future.
This is because, as the child grows, the same muscles or another group of muscles may become tight and lead to contractures that will require surgical intervention.