Last updated: 02/17/2009

Tenotomy is performed in order to lengthen a muscle that has developed improperly, or become shortened and is resistant to stretch.

Club foot is a common developmental deformity in which the foot is turned inward, with shortening of one or more...

of the muscles controlling the foot and possibly some bone deformity as well.

A muscle can become shortened and resistant to stretch when it remains in a shortened position for many months. When this occurs, the tendon that attaches muscle to bone can shorten, and the muscle itself can develop fibrous tissue within it, preventing it from stretching to its full range of motion. This combination of changes is called contracture.

Contracture commonly occurs in upper motor neuron syndrome following spinal cord injury; traumatic brain injury; stroke; multiple sclerosis; or cerebral palsy. Damage to the nerves controlling muscles lead to an imbalance of opposing muscle forces across a joint, which may allow one muscle to pull harder than another. For instance, excess pull from the biceps, unless opposed by the triceps, can bend the elbow joint. If the shortened bicep remains in this position, it will develop contracture, becoming resistant to stretching. Tenotomy is performed to lengthen the tendon, allowing the muscle to return to its normal length and allowing the joint to straighten.

When one muscle pulls much more strongly than its opposing muscle, it may cause the joint to become partially dislocated, which is called subluxation. Tenotomy is also performed to prevent or correct subluxation, especially of the hip joint in cerebral palsy.

Chronic pain or bone deformity may prevent a person from moving a joint through its full range of motion, leading to contracture.

Contracture also occurs in a variety of neuromuscular diseases, including muscular dystrophies and polio. Degeneration of one muscle can allow the opposing muscle to pull too hard across the joint, shortening the muscle.