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Endoscopic gastrocnemius recession: evaluation in a cadaver model
Robert Z Tashjian1, A Joshua Appel, Rahul Banerjee
1Department of Orthopedic Rhode Island Hospital, Brown University School of Medicine, Providence, RI, USA.
Foot & Ankle International
|September 6, 2003
Summary
This study introduces an endoscopic gastrocnemius recession technique. While effective for aponeurosis transection, it presents challenges in sural nerve visualization and carries a risk of injury.
Area of Science:
- Orthopedic Surgery
- Minimally Invasive Procedures
- Anatomy
Background:
- Gastrocnemius recession is a surgical procedure to treat conditions like equinus deformity.
- Traditional open techniques carry risks of scarring and infection.
- Endoscopic approaches offer potential benefits in reducing invasiveness.
Purpose of the Study:
- To describe a novel endoscopic gastrocnemius recession technique using a two-portal approach.
- To evaluate the accuracy of incision placement for this endoscopic method.
- To assess procedural outcomes including sural nerve visualization and ankle dorsiflexion.
Main Methods:
- Fifteen fresh-frozen cadaveric limbs were used for endoscopic gastrocnemius recession.
- A two-portal technique was employed.
- Anatomical dissection followed the procedure to assess sural nerve integrity and incision accuracy.
Main Results:
- Complete gastrocnemius aponeurosis transection (100%) was achieved in 8/15 specimens after technique modification.
- Sural nerve injury occurred in one specimen (7%) due to poor visualization.
- Mean ankle dorsiflexion improved by 20 degrees; the procedure averaged 20 minutes.
- Sural nerve visualization was achieved in only 33% of specimens.
Conclusions:
- Modified endoscopic gastrocnemius recession can achieve complete aponeurosis transection.
- Poor sural nerve visualization during the procedure poses a risk of iatrogenic injury.
- Further refinement is needed to improve nerve safety in endoscopic gastrocnemius recession.
