Gastrocnemius Recession or Tendo-Achilles Lengthening for Equinus Deformity in the Diabetic Foot?

Greenhagen, Robert M.; Johnson, Adam R.; Bevilacqua, Nicholas J.

doi:10.1016/j.cpm.2012.04.005

Cited by 30 publications

(28 citation statements)

References 45 publications

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“…This is especially prevalent in diabetic patients who have been shown to have increased density of collagen fibrils within the Achilles tendon that leads to stiffness and lack of motion. 31,32 It is also well established that an equinus contracture leads to increased plantar pressures, which increases the risk of ulceration or failure of partial foot amputation. [32][33][34][35][36][37][38] Correcting and preventing this deformity can increase the success of these amputations and allow for a better functional result.…”

Section: Gastrocnemius-soleus Complexmentioning

confidence: 98%

Soft Tissue Balancing After Partial Foot Amputations

Garwood

Steinberg

2016

Clinics in Podiatric Medicine and Surgery

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Section: Gastrocnemius-soleus Complexmentioning

confidence: 98%

Soft Tissue Balancing After Partial Foot Amputations

Garwood

Steinberg

2016

Clinics in Podiatric Medicine and Surgery

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“…There have been many radiological, clinical and anatomic studies in adults with respect to the morphometry of achilles tendinopathy (Greenhagen et al, 2012;Kim et al, 2010;Talsnes & Sudmann, 1992). Doral et al, in a study they conducted, studied and analyzed the achilles tendon functionally and anatomically.…”

Section: Introductionmentioning

confidence: 99%

A Study on the Structure and Morphologic Development of Calcaneal Tendon and Triceps Surae Muscle in Human Fetuses during the Fetal Period and the Evaluation of Clinical Importance of Calcaneal Tendon

et al. 2015

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SUMMARY: It was aimed that the morphometric development of calcaneal tendon and the structures building it up in human fetuses during the fetal period be anatomically studied and that its clinical importance be evaluated. The study comprised a total of 102 fetus legs (51 human fetuses: 26 male and 25 female) whose ages varied between 15-40 gestational week, without external pathology or anomaly. The fetuses were divided in groups according to gestational weeks, trimesters and months. In the wake of the general external measurements of fetuses, leg dissection was performed. Afterwards, the morphometric parameters of gastrocnemius muscle, soleus muscle and calcaneal tendon were measured. The averages and the standard deviations of the measured parameters were determined according to gestational weeks, trimesters and months. There was a significant correlation between the measured parameters and the gestational age (p<0.001). There was no difference between sexes in terms of parameters (p>0.005). All the obtained results were discussed by making a comparison between them and the previous studies made. We are of the opinion that the data obtained in our study will be of use to the involved clinicians in the evaluation of the development of calcaneal tendon and the structures constituting it during the fetal period and in clinical studies and applications as well.

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“…GSR is an effective and safe procedure for dealing with equinus contractures [7,13,14,16]. A literature search revealed a wide range of reported frequencies of ankle equinus with tibial lengthening.…”

Section: Introductionmentioning

confidence: 99%

“…Studies report an incidence range from 10% to 50% depending on the etiology of shortening [1,19]. The resulting equinus contracture can lead to a disruption in ankle, foot, and gait function [7]. Maskill et al [12] reported that patients with equinus contractures can also develop plantar fasciitis, metatarsalgia, posterior tibial tendon insufficiency, osteoarthritis, and foot ulcers.…”

Section: Introductionmentioning

confidence: 99%

What Risk Factors Predict Usage of Gastrocsoleus Recession During Tibial Lengthening?

Rozbruch

Zonshayn

Muthusamy

et al. 2014

Clin Orthop Relat Res

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Background Tibial lengthening is frequently associated with gastrocsoleus contracture and some patients are treated surgically. However, the risk factors associated with gastrocsoleus contracture severe enough to warrant surgery during tibial lengthening and the consistency with which gastrocsoleus recession (GSR) results in a plantigrade foot in this setting have not been well defined. Questions/purposes We compared patients treated with or without GSR during tibial lengthening with respect to (1) clinical risk factors triggering GSR use, (2) ROM gains and patient-reported outcomes, and (3) complications after GSR. Methods Between 2002 and 2011, 95 patients underwent tibial lengthenings excluding those associated with bone loss; 82 (83%) were available for a minimum followup of 1 year. According to our clinical algorithm, we performed GSR when patients had equinus contractures of greater than 10°while lengthening or greater than 0°before or after lengthening. Forty-one patients underwent GSR and 41 did not. Univariate analysis was performed to assess independent associations between surgical characteristics and likelihood of undergoing GSR. A multivariate regression model and receiver operating characteristic curves were generated to adjust for confounders and to establish risk factors and any threshold for undergoing GSR. Chart review determined ROM, patient-reported outcomes, and complications. Results Amount and percentage of lengthening, age, and etiology were risk factors for GSR. Patients with lengthening of greater than 42 mm (odds ratio [OR]: 4.13; 95% CI: 1.82, 9.40; p = 0.001), lengthening of greater than 13% of lengthening (OR: 3.88; 95% CI: 1.66, 9.11; p = 0.001), and congenital etiology (OR: 1.90; 95% CI: 0.86, 4.15; p = 0.109) were more likely to undergo GSR. Adjusting for all other variables, increased amount lengthened (adjusted OR: 1.05; 95% CI: 1.02, 1.07; p \ 0.001) and age (adjusted OR: 1.02; 95% CI: 0.99, 1.05; p = 0.131) were associated with undergoing GSR. Patients gained 24°of ankle dorsiflexion after GSR. Selfreported functional outcomes were similar between patients with or without GSR. Complications included stretch injury to the posterior tibial nerve leading to temporary and partial loss of plantar sensation in two patients.

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Gastrocnemius Recession or Tendo-Achilles Lengthening for Equinus Deformity in the Diabetic Foot?

Cited by 30 publications

References 45 publications

Soft Tissue Balancing After Partial Foot Amputations

Soft Tissue Balancing After Partial Foot Amputations

A Study on the Structure and Morphologic Development of Calcaneal Tendon and Triceps Surae Muscle in Human Fetuses during the Fetal Period and the Evaluation of Clinical Importance of Calcaneal Tendon

What Risk Factors Predict Usage of Gastrocsoleus Recession During Tibial Lengthening?

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