Question of Bones

Big points to my cousin in Florida for asking a great question about muscles vs. bones.

If you have no idea what we are even talking about, read this post first. It will fill you in on Chloe’s upcoming surgery.

My cousin’s question is: “Is shortening the bone easier than ‘stretching’ the muscles and tendons?”

I nearly addressed this in my original surgery post, but it was getting so long I decided not to. But it brings up a couple of really good points that are key to why this surgery is the better fit for Chloe.

First, the short answer is that NO, shortening the bone is NOT easier than manipulating tendons and muscles. Both the skill and difficulty of the surgery itself and of the recovery time and process would be way simpler and easier if it were only involving muscles and tendons.

Lengthening or releasing muscles and tendons is a great and helpful procedure for many patients. However, there are 2 main reasons that this femur extension surgery is a better fit for Chloe at this time.

First, the doctor is wanting to fix a greater degree of angle than a tendon/muscle procedure would fix. In fact, the doctor’s goal for Chloe’s surgery is to fix 45-50 degrees of her contracture! That’s a significant change. And it’s not a change that a tendon/muscle release would accomplish. If I remember correctly, a tendon/muscle release fixes closer to 10-15 degrees. Chloe’s contracture is significantly worse than that.

The other big reason this femur surgery is a better fit for Chloe is that the end goal is increased function. If the only goal were straightening, then a different surgery might be an easier option. But since the end goal is more functionality in walking and standing for Chloe, then it is important to keep the muscles and tendons more intact. Simply put, if we go to snipping those muscles, then she loses the functionality of controlling them for walking and getting around.

I did mention though that the doctor does plan to slightly release her tendon at the hips. He is going to do it quite conservatively so as not to lose that function. This tendon portion will be an easy surgery to go back and do again if we decide he needs to release it some more later. But for now, erring on the conservative side is the best choice for her. Time will tell if she would benefit from any releasing later on.

So again, thanks for the great question. And don’t hesitate to ask some more.

(*disclaimer: I am obviously not a doctor… These posts are my way of updating friends and family on Chloe’s upcoming surgery, not to be the final word on medical procedures or judgements.  These posts are purposely written in a very simplified and general way so as not to run everyone off with crazy vocabulary and medical talk. And guess what? I might mis-speak the logistics now and then so don’t be citing the journals on me…. I’m communicating the general idea, and it’s okay.  Thanks. :))
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