Soft Tissue Lengthening — Hamstring Lengthening (Open Z-Plasty and Fractional)

Children's Colorado / Center for Gait and Movement Analysis (CGMA) · CGMA Physical Therapy Team, Children's Colorado

Weight-Bearing

Protected WB per MD x 3-4 weeks; long leg or cylinder cast with knee extended; WBAT per MD after cast

Key Restrictions

No forceful/resisted hamstring contraction x 6 weeks; no impact x 6 weeks; possible post-op dysesthesia calf/foot lasting months (contact MD if limiting rehab); knee immobilizers at night after cast removal

Timeline & Phases

Phase 1 (days 1-7): 10 min sustained long sitting every hour awake, isometrics (glutes/quads), ankle AROM; Phase 2 (days 8-21): sub-maximal (<50%) isometric hamstring, SLR; Phase 3 (day 22+): scar mobility, knee extension in gait/terminal stance, anti-crouch/upright posture, hamstring flexibility, total LE strengthening

Notes

Pediatric; indication is hamstring contracture and crouch gait; gracilis/semitendinosus z-plasty + fractional semimembranosus/biceps femoris lengthening; Children's Colorado CGMA

Surgeon / Author

CGMA Physical Therapy Team, Children's Colorado

Published

October 2007