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Calf lengthening surgery

Why does my child need calf lengthening surgery?

The calf muscles, at the back of the lower leg can become tight. This tightness can develop due to a combination of factors including over activity in the muscles relating to your child’s condition, growth and poor compliance with splints.

When the muscles get tight it can lead to a number of problems with standing, walking and accessing equipment and splints. Stretching and splints can help prevent this tightness but are not always enough to improve the position once it has deteriorated.

How can an operation help my child?

An operation to lengthen these muscles can help your child have a more stable base for standing and walking. It can allow for an improved standing position and walking pattern. Your child’s abilities after the operation will depend on their previous abilities.

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. Through this small opening, little cuts are made into the tight muscles or tendon so they can be stretched and made longer. The operation to lengthen the calf muscles is done under a general anaesthetic where your child is asleep.

After the operation children may be able to go home the same day but often need to stay in hospital overnight, the length of their stay in hospital will depend on how comfortable they are and how safe they are moving around. A cast will be put on at the end of the operation from below the knee down to their toes to help the muscles heal in their new lengthened position.

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 carried out a minimum of 3 times a day. Your child will be given gaiters or braces which are splints to help keep their legs straight to help with stretching.

Illustration of child laid down with their legs stretched out in gaiters

Your child will be able to put all their weight through their legs, unless they have had bony surgery at the same time. They will be encouraged to stand and walk as they are able and will be given plaster shoe to fit over their cast.

Illustration of child laid down with a plaster boot on their foot

The therapy team at the hospital will speak to your child’s local physiotherapist when they’re discharged. They will ask that they arrange to see your child when they are home and pass on any important information.

What happens after leaving hospital?  

You will come back between 2 to 4 weeks after the operation. The cast will be removed and they will be measured for a splint. This will take around 2 weeks to be made and your child will go back into a cast until the splint is ready. The splint should be worn at all times once the cast is removed to maintain the length of the calf muscles. At 3 months after the operation the time in the splint can be reduced but this should be discussed with your child’s consultant or physiotherapist.

Illustration of side view of a child sitting with their leg out with a brace on their leg

What happens next?

You should continue to support your child with exercises and positioning advice provided by your child’s therapists. Your child’s physiotherapist will monitor their ability to walk, stand and move as well as their muscle’s flexibility. If your child is able to walk independently or with a walker and they had a gait analysis before their operation their surgeon may arrange to have this repeated.

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Disclaimer

Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

Resource number: ORP11

Resource Type: Article

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S10 2TH

United Kingdom

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