Adductor lengthening surgery

Why does my child need adductor muscle surgery?

When a child develops tightness in the muscles on the inside of the legs they will struggle taking their legs out to the side. These muscles are called the adductor muscles.

The tightness can cause the legs to cross over making standing, walking, washing and dressing very difficult. This tight can be a sign that they are developing hip displacement. Hip displacement is when the ball of the hip joint moves out of the socket.

If the adductor muscles stay tight they can cause hip displacement to increase.

How can surgery help?

An operation to lengthen these muscles should make it easier for your child to move their legs. It can make activities like washing and dressing more manageable because it is easier to move the legs out to the side. It can also help to slow down the progression of hip displacement.

There are risks, as with any operation and the surgeons will go through these with you. It may not be possible to get the knees fully straight with this operation.

Your orthopaedic team will discuss the options and what is best for your child and family. You will have the opportunity to ask any questions you may have.

What does the operation involve?

The operation is done through a small cut in the skin at the groin. Through this small opening, little cuts are made into the tight muscles so they can be stretched and made longer.

The operation to release the adductor muscles is done under a general anaesthetic where your child is asleep.

After the operation children usually need to stay in hospital for 1 to 2 days but the length of their stay in hospital will depend on how comfortable they are.

What will happen after the operation?

After muscle lengthening surgery it is important for the muscle to heal in the new lengthened position. The therapy team will see your child on the ward after their operation. They will go through exercises, positive positions and things you can do to help your child get the most from their surgery. After the operation exercises will need to be done a minimum of 3 times a day.

Your child may have a cast put on at the end of the operation to maintain a positive position. This type of cast is called a broomstick cast and will often be on for between 2 to 4 weeks.

The therapists will go through how to look after the cast and care for your child whilst they’re wearing it.

If your child is not planned to have a broomstick cast they will be given an abduction wedge and gaiters. The abduction wedge is a shaped pillow that sits between the legs to keep them apart. Gaiters are splints worn on the legs to keep them straight.

Both help achieve a positive position for healing and should be used day and night for the first 2 weeks then dropping to overnight and when able during the day after this time.

When planning for this operation it is important to consider the level of care and input your child will need afterwards.

Your child will be able to put all their weight through their legs after the operation, unless they have had bony surgery at the same time. They will be encouraged to stand and walk as they are able.

The therapy team at the hospital will speak to your child’s local physiotherapist requesting they see them after discharge and pass on any important information.

What happens after we leave the hospital?

An appointment will be arranged for you to come back to clinic. A new hip X-ray might be taken to check the position and shape of the hips and the amount of movement in your child’s hips will also be looked at.

What happens next?

It is important for your child to continue having hip checks so their doctor and physiotherapist can keep an eye on the position of their hips.