Proximal Medial Gastrocnemius Release in the Treatment of Recalcitrant Plantar Fasciitis

Abstract

We believe a PMGR is a simple way of treating a patient with PF who has failed to respond to conservative management. In our series, the results were favorable, the recovery fast and the morbidity low.

Chronic plantar fasciitis: Plantar fasciotomy versus gastrocnemius recession

“…In a prospective study, the PMGR has shown excellent results in the treatment of recalcitrant plantar fasciitis [4]. Our results in the PMGR group are almost identical.…”

“…More recently this technique has been modified so that only the medial head of the gastrocnemius is released through a small posterior incision, placed more medially [4]. Additionally, the approach to the medial head was less likely to risk cutaneous nerve damage.…”

“…Likert scale was used for the evaluation of treatment success. No outcome tools have been validated for CPF, but the Likert scale is a patient-reported outcome satisfaction scale which has been used in other studies [4]. Calf power was analysed objectively by asking patients to perform a one-minute single stance heel rise test on the operated side, at three and six months from surgery.…”

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

“…A recent anatomic study revealed that the superficial part of the Achilles tendon is mainly from the medial head of the gastrocnemius and has continuity with the plantar fascia [22]. Only releasing the medial head may safely achieve a relatively satisfactory correction of the contracture [10,23,24]. However, patients with a larger equinus contracture of more than 15°of plantar flexion may still suffer from some degree of equinus postoperatively [10].…”

Lateral Plantar Nerve Release with or without Calcaneal Drilling for Resistant Plantar Fasciitis

“…16 Various surgical procedures have been used for the treatment of resistant plantar fasciitis, but the outcome varies, 14 owing to the diversity of the underlying pathology (such as entrapment of the first branch of lateral plantar nerve, tight Achilles tendon, increased calcaneal intra-osseous pressure and venous congestion, calcaneal periostitis, and presence of calcaneal spur). 5,6,11,14,15,17 Spur excision can be through a medial incision. 18 The optimal site for drilling multiple holes in the calcaneus remains controversial.…”