Partial Postero-Medial Superficial Release of the Proximal Crural Fascia in Patients with Positive Silfverskiold's Test: Case Series of Clinical Outcomes and Novel Technique
| Autor: | Ivan Mattos, Mohammad T. Azam BS, Hugo A. Ubillus MD, Matthew B. Weiss BS, John G. Kennedy MD, FRCS(Orth) |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Foot & Ankle Orthopaedics, Vol 7 (2022) |
| Druh dokumentu: | article |
| ISSN: | 2473-0114 24730114 |
| DOI: | 10.1177/2473011421S00797 |
| Popis: | Category: Ankle; Hindfoot; Lesser Toes; Midfoot/Forefoot Introduction/Purpose: Ankle limitation to dorsiflexion in an extended knee is observed during the second rocker of gait in patients with positive Silfverskiold test confirming an isolated gastrocnemius contracture (IGC). Tendons and muscles share intrinsic contractility and relaxation properties which can be modified during physiotherapy in comparison to the fascia which lacks it. The present study describes a case series of patients with positive Silfverskiold associated with various foot pathologies who underwent a selective fasciotomy of the postero-medial superficial portion of the crural fascia. The purpose of this study is to describe the surgical technique and clinical outcomes of this procedure. We hypothesize that this procedure can reach satisfactory clinical outcomes with the advantage of being a less invasive procedure. Methods: 26 patients treated with partial postero-medial superficial release (PMSR) of the crural fascia from January to October 2021 for IGC with associated chronic foot pain were included. Inclusion criteria considered patients with diagnosis of foot pain with IGC and positive Silfverskiold test. A transverse incision was made 2 cm distal to the flexion crease starting at the intermuscular line of the gastrocnemius muscle, 4 cm medially (Figure 1). Subcutaneous dissection was performed identifying the neurovascular bundle. A horizontal incision was performed to the superficial posterior fascia of the medial gastrocnemius head. The medial gastrocnemius muscle was not sectioned. Patients completed the FADI score previous to surgery and at final follow- up. Data was analyzed using SPSS 20. Paired samples T-tests were performed to identify significance of the difference in pain and function preoperatively and postoperatively with statistical significance set at p |
| Databáze: | Directory of Open Access Journals |
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