Surgical treatment of gastrocnemius muscle ruptures

Rupture of the medial head of the gastrocnemius, known as "tennis leg", typically occurs when the muscle has been overstretched by dorsiflexion of the ankle with full knee extension. The classic clinical presentation is a middle-aged person who complains of sports-related acute pain in the mid portion of the calf, associated with a snapping sensation. Magnetic resonance imaging (MRI) or ultrasound is often required to evaluate patients with this condition. This injury is usually managed non-operatively, surgical treatment rarely being indicated according to published reports. One case of longstanding and one of recent rupture of the musculotendinous junction of the medial head of the gastrocnemius that were successfully treated by surgical repair are presented here and the MRI characteristics and indications for surgery are discussed.