Release or recession, hamstring, proximal
CPT4 code
Name of the Procedure:
Release or Recession, Hamstring, Proximal
Common Names: Hamstring Release, Proximal Hamstring Recession
Summary
Hamstring release or recession is a surgical procedure aimed at lengthening the hamstring muscles at their proximal (upper) attachment. It is often performed to correct issues related to tight or contracted hamstrings that can impair movement.
Purpose
This procedure addresses conditions such as hamstring contractures, spasticity, or tightness commonly seen in patients with cerebral palsy, spastic quadriplegia, or other neuromuscular disorders. The goal is to enhance mobility, alleviate pain, and improve the overall functioning of the legs.
Indications
- Severe hamstring tightness or contractures
- Cerebral palsy or other neuromuscular disorders causing spasticity
- Difficulty walking or maintaining proper leg positioning
- Persistent pain despite conservative treatments
Preparation
- Pre-operative physical and neurological evaluation
- Imaging studies, such as MRI or X-rays, may be required
- Patients may need to fast for 8-12 hours before surgery
- Medications may need to be adjusted or paused
Procedure Description
- Anesthesia: General or regional anesthesia is administered.
- Incision: A small incision is made near the upper attachment of the hamstring muscles.
- Muscle Release: The surgeon locates the hamstring tendons and carefully detaches or repositions them to reduce tension.
- Closure: The incision is closed with sutures or staples.
- Stabilization: In some cases, a brace or cast is applied to stabilize the leg during initial recovery.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
Surgery is usually performed in a hospital or an outpatient surgical center.
Personnel
- Surgeon (orthopedic or neurosurgeon)
- Anesthesiologist
- Surgical nurses and assistants
Risks and Complications
- Infection
- Bleeding or hematoma
- Nerve damage or numbness
- Incomplete release or recurrence of tightness
- Scarring or adhesion formation
Benefits
- Improved leg movement and flexibility
- Reduced pain and spasticity
- Enhanced ability to walk and perform daily activities
- Typically, benefits are noticeable within a few weeks after surgery.
Recovery
- Initial recovery involves rest and limited movement, often requiring crutches or a walker.
- Physical therapy is crucial for regaining strength and flexibility.
- Recovery time varies but typically spans several weeks to a few months.
- Follow-up appointments are necessary to monitor progress.
Alternatives
- Physical therapy and stretching exercises
- Botox or other muscle relaxant injections
- Orthotic devices or braces
- Less invasive surgical options, depending on the severity and underlying condition
Patient Experience
During the procedure, the patient will be under anesthesia and will not feel pain. Post-surgery, pain and discomfort are managed with prescribed medications. Patients may experience initial soreness and will gradually return to normal activities as guided by their healthcare team. Physical therapy plays a critical role in a smooth and effective recovery.