Advertisement
Original Research| Volume 51, ISSUE 6, P714-719, November 2012

Download started.

Ok

Uniportal Endoscopic Gastrocnemius Recession for Treatment of Gastrocnemius Equinus with a Dedicated EGR System with Retractable Blade

Published:September 17, 2012DOI:https://doi.org/10.1053/j.jfas.2012.08.002

      Abstract

      This study examined the effectiveness and safety of a uniportal endoscopic gastrocnemius recession with a specifically designed uniportal endoscopic system. Fifty-three patients underwent 60 endoscopic gastrocnemius recessions. Their mean range of ankle dorsiflexion changed from a preoperative value of –2.9° ± 1.9° to a postoperative value of 12.8° ± 1.7°, for a total increase of 15.7° ± 1.8° of ankle dorsiflexion (p < .001). The average time from skin incision to closure was 4 minutes and 19 ± 33.6 seconds. Overall, 4 (6.67%) cases (procedures) were associated with a complication, including 1 (1.67%) case of triceps surae weakness that resolved after physical therapy. Three (5%) cases developed nerve complications, with 2 (3.33%) cases of transient neuritis that spontaneously resolved at 5 and 8 weeks postoperatively, respectively, and 1 (1.67%) that experienced persistent cutaneous anesthesia in the distribution of the sural nerve along the lateral aspect of the foot up to 4 months postoperatively. There were no cases of wound dehiscence or delayed healing, painful scar formation, infection at the surgical site, hematoma, or deep venous thrombosis. Endoscopic gastrocnemius recession with a uniportal system appears to be safe and effective.

      Level of Clinical Evidence

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Foot and Ankle Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • DiGiovanni C.W.
        • Kuo R.
        • Tejwani N.
        • Price R.
        • Hasen Jr., S.T.
        • Cziernecki J.
        • Sangeorzan B.J.
        Isolated gastrocnemius tightness.
        J Bone Joint Surg Am. 2002; 84-A: 962-970
        • Root M.L.
        • Orien W.P.
        • Weed J.H.
        Normal and Abnormal Function of the Foot.
        Clinical Biomechanics Corporation, Los Angeles1977
        • Cheung J.T.
        • Zhang M.
        • An K.
        Effect of Achilles tendon loading on plantar fascia tension in the standing foot.
        Clin Biomech. 2006; 21: 194-203
        • Mueller M.J.
        • Sinacore D.R.
        • Hastings M.K.
        • Strube M.J.
        • Johnson J.E.
        Effects of Achilles tendon lengthening on neuropathic plantar ulcers. A randomized clinical trial.
        J Bone Joint Surg Am. 2003; 85-A: 1436-1445
        • Vulpius O.
        • Stoffel A.
        Tenotmie der end schnen der mm. gastroc el soleus mittels rutschenlassens nach vulpius.
        in: Orthopadische Operationslehre. Ferdinard Enke, Stuttgart1913: 29-31
        • Pinney S.J.
        • Hansen Jr., S.T.
        • Sangeorzan B.J.
        The effect of ankle dorsiflexion on gastrocnemius recession.
        Foot Ankle Int. 2002; 23: 26-29
        • Pinney S.J.
        • Sangeorzan B.J.
        • Hansen Jr., S.T.
        Surgical anatomy of the gastroc recession (strayer procedure).
        Foot Ankle Int. 2004; 25: 247-250
        • Roukis T.S.
        • Schweinberger M.H.
        Complications associated with uni-portal endoscopic gastrocnemius recession in a diabetic patient population: an observational case series.
        J Foot Ankle Surg. 2010; 49: 68-70
        • Saxena A.
        • Widtfedt A.
        Endoscopic gastronemius recession: preliminary report on 18 cases.
        J Foot Ankle Surg. 2004; 43: 302-306
        • Saxena A.
        • Gollwitzer H.
        • Widtfeldt A.
        • DiDomenico L.A.
        Endoscopic gastrocnemius recession as therapy for gastrocnemius equines.
        Z Orthop Unfall. 2007; 145: 499-504
        • DiDomenico L.A.
        • Adams H.B.
        • Garchar D.
        Endoscopic gastrocnemius recession for the treatment of gastrocnemius equinus.
        J Am Podiatr Med Assoc. 2005; 95: 410-413
        • Trevino S.
        • Gibbs M.
        • Panchbhavi V.
        Evaluation of results of endoscopic gastrocnemius recession.
        Foot Ankle Int. 2005; 26: 359-364
        • Adelman V.R.
        • Szczepanski J.A.
        • Adelman R.P.
        • Lincolon D.R.
        Endoscopic gastrocnemius recession: ultrasound-guided analysis of length gained.
        Tech Foot Ankle Surg. 2009; 8: 24-29
        • Grady G.F.
        Endoscopic gastrocnemius recession for treating equinus in pediatric patients.
        Clin Orthop Relat Res. 2010; 468: 1033-1038