Gastrocnemius Recession as an Alternative to TendoAchillis Lengthening for Relie

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J Foot Ankle Surg. 2010 Feb 3

Gastrocnemius Recession as an Alternative to TendoAchillis Lengthening for

Relief of Forefoot Pressure in a Patient with Peripheral Neuropathy: A Case

Report and Description of a Technical Modification.

Greenhagen RM, AR, MC, LC, Bevilacqua NJ.

Second-year resident, University of Pittsburgh Medical Center, Pittsburgh, PA.

The gastrocnemius recession is a popular surgical procedure for the treatment of

equinus contracture. Lengthening the gastrocnemius tendon has been show to be an

effective means of reducing pressure to the plantar forefoot by weakening the

triceps surae complex. The more traditional method of weakening the triceps

surae is a modification of Hoke's triple hemisection through the tendoAchillis.

This technique unfortunately carries a serious risk of the development of a

calcaneal gait.

The purpose of this case report is to demonstrate that the gastrocnemius

recession is an effective and safe alternative to the traditional tendoAchillis

lengthening. The authors also describe a minimally invasive technique that uses

a pediatric speculum for a self-retrained retractor and portal for

instrumentation and visualization.