Lengthening of the Gastrocnemius-Soleus Complex

Abstract

Surgical procedures for the correction of equinus deformity by lengthening of the gastrocnemius-soleus complex vary in terms of selectivity, stability, and range of correction. Procedures for the correction of equinus deformity have different anatomical and biomechanical characteristics. Clinical trials are needed to determine whether these differences are of clinical importance. It may be appropriate for surgeons to select a procedure involving the zone best suited to the clinical needs of a specific patient.

Comparison of the efficacy of three isolated gastrocnemius recession procedures in a cadaveric model of gastrocnemius tightness

“…In previous studies, formaldehyde-preserved specimens were usually used to compare different techniques for lengthening the gastrocnemius-soleus complex [14,16]. The equinus deformity is induced by gravity and the postmortem shortening of soft tissue after formaldehyde preservation [14].…”

“…The equinus deformity is induced by gravity and the postmortem shortening of soft tissue after formaldehyde preservation [14]. However, because both the gastrocnemius and the soleus were shortened, that model is only suitable for triceps surae equinus.…”

“…After the gastrocnemius recession procedures, as described in previous studies [14,16], a progressive dorsiflexion force was applied to the metatarsal heads with the knee extended. Because the formaldehyde preservation can lead to approximately five-fold increase in muscle stiffness, the dorsiflexion force on our fresh cadavers was increased from 4 to 10 kg, using an increment of 2 kg, which is one fifth of the forces used with formaldehyde-preserved specimens [14,16].…”

“…Because the formaldehyde preservation can lead to approximately five-fold increase in muscle stiffness, the dorsiflexion force on our fresh cadavers was increased from 4 to 10 kg, using an increment of 2 kg, which is one fifth of the forces used with formaldehyde-preserved specimens [14,16]. At each level of the applied dorsiflexion force, the distance between the ends of the incised aponeurosis was measured with a vernier caliper.…”

“…The indications of these procedures remain unclear. Recently, a study [14] compared the lengthening procedures of the gastrocnemius-soleus complex using normal formaldehyde-preserved cadavers; however, both the gastrocnemius and soleus muscle tissues were stiff and resisted lengthening, and proximal gastrocnemius recession was not included. To our knowledge, there have been no reports directly comparing the efficacy and stability after these isolated gastrocnemius recession procedures, particularly on a cadaveric model of gastrocnemius tightness.…”