Many different procedures are used to release muscle contractures:
- Detachment of the involved muscle from its proximal insertion on the bone. This is used mainly for the muscles which flex the wrist (wrist flexors), and the fingers (finger flexors).The procedure is referred to as “medial epicondylar release”, or “SCAGLIETTI-PAGE” technique.
- Distal section of the muscle tendon: “tenotomy”. This simple procedure is often performed for the tendons of the wrist flexors: (flexor carpi radialis FCR, and mostly flexor carpi ulnaris FCU)
- Lengthening the muscle at the tendon/muscle junction (fractional lengthening) or within the tendon (Z lengthening).
- The STP technique consists in lengthening the finger flexors in severely contracted fingers (clenched fist) with little or no movement.
After surgery, the limb is usually protected by a splint for 4 weeks, and physiotherapy is started immediately, except for the “Z” technique, where it is only started after 4 weeks.