Anatomical basis of a safe mini-invasive technique for lengthening of the anterior gastrocnemius aponeurosis
| Autor: | Alejandro Fernández-Gibello, Gabriel Camunas Nieves, Teresa Vázquez, Ruben Montes, Marko Konschake, Bernhard Moriggl, Maria Garcia-Escudero, Simone Moroni, Fabrice Duparc, Marit Zwierzina |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Metatarsalgia medicine.medical_specialty Plantar fasciitis Pathology and Forensic Medicine 03 medical and health sciences Gastrocnemius muscle 0302 clinical medicine Ultrasound medicine Humans Minimally Invasive Surgical Procedures Orthopedic Procedures Radiology Nuclear Medicine and imaging Aponeurosis Minimally invasive Muscle Skeletal Ultrasonography Interventional 030222 orthopedics 0303 health sciences business.industry medicine.disease Surgery Anatomic Bases of Medical Radiological and Surgical Techniques medicine.anatomical_structure 030301 anatomy & morphology Orthopedic surgery Female Anatomy Ankle medicine.symptom Tendinopathy Contracture business |
| Zdroj: | Surgical and Radiologic Anatomy |
| ISSN: | 1279-8517 0930-1038 |
| DOI: | 10.1007/s00276-020-02536-1 |
| Popis: | Background The surgical procedure itself of lengthening the gastrocnemius muscle aponeurosis is performed to treat multiple musculoskeletal, neurological and metabolical pathologies related to a gastro-soleus unit contracture such as plantar fasciitis, Achilles tendinopathy, metatarsalgia, cerebral palsy, or diabetic foot ulcerations. Therefore, the aim of our research was to prove the effectiveness and safety of a new ultrasound-guided surgery-technique for the lengthening of the anterior gastrocnemius muscle aponeurosis, the “GIAR”- technique: the gastrocnemius-intramuscular aponeurosis release. Methods and results An ultrasound-guided surgical GIAR on ten fresh-frozen specimens (10 donors, 8 male, 2 females, 5 left and 5 right) was performed. Exclusion criteria of the donated bodies to science were BMI above 35 (impaired ultrasound echogenicity), signs of traumas in the ankle and crural region, a history of ankle or foot ischemic vascular disorder, surgery or space-occupying mass lesions. The surgical procedures were performed by two podiatric surgeons with more than 6 years of experience in ultrasound-guided procedures. The anterior gastrocnemius muscle aponeurosis was entirely transected in 10 over 10 specimens, with a mean portal length of 2 mm (± 1 mm). The mean gain at the ankle joint ROM after the GIAR was 7.9° (± 1.1°). No damages of important anatomical structures could be found. Conclusion Results of this study indicate that our novel ultrasound-guided surgery for the lengthening of the anterior gastrocnemius muscle aponeurosis (GIAR) might be an effective and safe procedure. |
| Databáze: | OpenAIRE |
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