SPMLs & EtOH

A 6 year old boy from New Zealand pops in because his mom was familiar with a family of a Tetralogy SPML patient. Essentially, do THAT to my kid. Nice kid, but, all energy. Pent up frustration trying but unable to walk. Then he did this:

In our suburb office, he ‘knee walked’ to the end of the hallway where we wanted him [also known as ‘tall crawl’ using no hands, on walls or floor]. We couldn’t say no to that, a really good indication of what is needed to walk unsupported. We were, then, only doing our cases of SPML under local anesthesia. Tetralogy kids knew to be still from all the stuff they have been through. Not this guy. It was a job holding him still and his medial hamstrings were like bow strings. They were the obvious target. The semitendinosus is a muscle that is relatively small with a really long tendon that sports and reconstructive surgeons remove without hesitation in order to replace knee ligaments and lots of other more needy things. It is not missed