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Background Strayer’s gastrocnemius recession is a common technique in treating ankle equinus of gastrocnemius origin. Nevertheless, this technique is associated with a few flaws. We aim to introduce a novel technique of isolated gastrocnemius recession and perform a cadaveric study to evaluate its safety and at the same time compare this novel technique with the existing Strayer procedure biomechanically. Methods Eight fresh cadaveric models of gastrocnemius tightness were established by isolated traction of the gastrocnemius muscles. Gastrocnemius recession was performed on all eight models with Strayer method and the novel method randomized equally. The safety of both the techniques was evaluated by identifying any iatrogenic injury to the surrounding structures. The lengthening and improvement of the ankle dorsiflexion was measured and compared between the two techniques. Results There was no iatrogenic sural nerve or saphenous vein injury in all eight models. There was no significant difference between the two techniques in terms of lengthening (24.25 mm vs 21.00 mm; p = 0.838) and improvement of ankle dorsiflexion (26.5° vs 26°; p = .829). Conclusions Both Strayer technique and the novel technique of gastrocnemius recession lengthened the gastrocnemius and improved the ankle dorsiflexion in this cadaver trial. Both procedures were safe with proper techniques, and there was no significant difference in efficacy between them. Level of Evidence Level II, randomized controlled trial.

Spinal Schwannoma originates from the Schwann cells, hence it is called Schwannoma. The tumor localization is in various parts of the spinal cord, but prevails in cervical and thoracic. In the literature 70 to 80% of spinal schwannomas are reported to be intradural in location, and 15% with both intradural and extradural components. All 3 cases were female in their 4th-5th decade, presented with either low back pain, radiculopathy, weakness of both lower limbs associated with urinary incontinence. MRI revealed a well defined mass adjacent to conus medullary area located intradural, extramedullary. All three patients underwent microscopic assisted excision of the tumour. All patients had Good Early Outcome. Spinal schwannoma causing Conus Medullary Syndrome is rare. Back pain and radicular pain were most common early presenting symptoms while urinary symptoms occur later. Schwannomas typically arise from a single nerve root originating from the schwann cells. To obtain total resection, the affected nerve root is commonly sacrificed in order to prevent recurrence. Intradural Extramedullary Schwannoma, even presented at a later stage with significant neurological deficit, has a Good Outcome post operatively owing to its Benign nature, Extramedullary location, and a Meticulous Microscopic assisted Complete Surgical Excision.

INTRODUCTION: Pedobarography has been widely used in developed countries for few decades. However, in Malaysia it is still in its infancy. Studies showed that the normal values of pedobarography vary between races. To the best our knowledge there is no standard value available for Malaysian or Southeast Asia. This study is designed to measure the pressure values in the normal foot of Malays in Pahang, Malaysia and its difference between different gender and body mass index (BMI). Materials and Methods: A total of 400 feet of adult Malay subjects with no existing diabetes mellitus, lower limb and spine pain or problem are measured using Emed-q100 pedobarography device. Results: 226 (56.5%) were females. 44.5% were with normal BMI followed by overweight (31.5%), and obese (24%). The mean-maximum-peak pressure (MPP) is 509kPa (SD 167) with no significant difference among gender and BMI. Most (38.5%, n=154) of the peak pressure area (PPA) are observed in 1st metatarsal head and big toe region (1MH&T), followed by 2nd metatarsal head (2MH) (34.3%, n=137). In the normal BMI group, 48.3% were in 1MH&T region while in the overweight and obese groups, 42.1% and 43.8%, respectively were in 2MH. This difference is significant (x2(df=8)=36.963, p<0.001). There was no significant difference between PPA and gender. ConClusion: The MPP among Malays in this study was 509kPa(SD 167) and it is not affected by different genders or BMI. The PPA are most commonly fall on 1MH&T. There is a significant shift in the overweight and obese groups to the 2MHT. This finding can be used as initial reference for further studies, in Malaysia particularly.