27005 Tenotomy, hip flexor(s), open (separate procedure)

Name of the Procedure:

Tenotomy, hip flexor(s), open

• Common Names: Hip flexor release, Open hip flexor tenotomy
• Technical/Medical Term(s): Open tenotomy of the hip flexor muscles

Summary

In layman's terms: This surgery involves making an incision to access and cut the hip flexor muscles. This helps relieve muscle tightness and improve movement.

Purpose

• Medical condition: Addresses conditions causing hip flexor tightness, such as spasticity from cerebral palsy or other neuromuscular disorders.
• Goals/Outcomes: To relieve pain, improve range of motion, and enhance the overall functionality of the hip.

Indications

• Persistent tightness or spasticity in the hip flexor muscles
• Limited range of motion in the hip causing functional impairment
• Pain or discomfort in the hip area not relieved by conservative treatments
• Typically performed in patients with conditions like cerebral palsy, muscular dystrophy, or acquired muscle contractures

Preparation

• Pre-procedure instructions: May include fasting for 6-8 hours, stopping certain medications as advised by the doctor.
• Diagnostic tests: Physical examination, imaging studies (like MRI or X-rays), and pre-anesthesia assessment.

Procedure Description

• The procedure begins with the patient being placed under general anesthesia.
• An incision is made near the hip area to access the hip flexor muscles.
• The surgeon carefully cuts the target hip flexor muscles to release them.
• The incision is then closed with sutures.
• Tools: Scalpels, retractors, surgical scissors
• Equipment: Anesthesia machine, monitoring devices

Duration

Typically takes about 1 to 2 hours to complete.

Setting

Performed in a hospital’s operating room or a specialized surgical center.

Personnel

• Surgeon (Orthopedic or Pediatric Surgeon)
• Nurses and Surgical Technicians
• Anesthesiologist

Risks and Complications

• Common Risks: Infection, bleeding, and bruising at the incision site.
• Rare Risks: Nerve damage, incomplete release requiring further surgery, adverse reactions to anesthesia.
• Management: Appropriate antibiotics, monitoring for infection, pain management, physical therapy for rehabilitation.

Benefits

• Expected benefits: Pain relief, improved mobility, and enhanced quality of life.
• Realization of benefits: Improvement can be noticed within weeks, although full benefits are often seen after several months of rehabilitation.

Recovery

• Post-procedure care: Pain management with medications, wound care, and physical therapy exercises.
• Recovery time: Generally ranges from 4 to 8 weeks, with activity restrictions as recommended by the healthcare provider.
• Follow-up: Regular appointments to monitor healing and progress with physical therapy.

Alternatives

• Non-surgical treatments: Physical therapy, medications, botox injections
• Pros: Less invasive, can be effective in mild cases.
• Cons: May not provide long-term relief or adequate functional improvement in severe cases.

Patient Experience

• During procedure: The patient will be under general anesthesia and not feel anything.
• After procedure: Expect some pain and swelling around the incision site. Pain is generally manageable with prescribed medications.
• Comfort measures: Ice packs, prescribed pain-relief medications, and support from physical therapists to ensure a smoother recovery journey.