Macroscopic changes in sural nerve after gastrocnemius recession: a cadaver study

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Procedures
• Anatomy

Background:

• Gastrocnemius recession is a common surgical procedure for foot and ankle conditions.
• The Baumann and Strayer techniques are frequently used, differing in gastrocnemius transection location.
• Both methods carry a risk of adverse effects on the sural nerve.

Purpose of the Study:

• To evaluate macroscopic changes in the sural nerve after gastrocnemius recession.
• To compare the efficacy of Baumann and Strayer procedures in improving maximal ankle dorsiflexion.
• To assess the impact of these surgical techniques on the sural nerve.

Main Methods:

• Ten cadaveric legs underwent either Baumann or Strayer gastrocnemius recession.
• Ankle dorsiflexion was measured using a goniometer before and after surgery.
• Sural nerve excursion and gastrocnemius muscle gap were quantified during passive dorsiflexion.

Main Results:

• Both techniques resulted in a mean 0.2 cm increase in sural nerve length between 90° and maximal dorsiflexion.
• Mean improvement in maximal ankle dorsiflexion was 22.6° for Baumann and 22° for Strayer.
• The mean change in gastrocnemius muscle gap was comparable between the two groups (1.0 cm for Baumann, 0.9 cm for Strayer).

Conclusions:

• Baumann and Strayer gastrocnemius recession yield similar macroscopic changes in the sural nerve.
• These nerve changes may contribute to the development of sural neuritis.
• Further clinical research is needed to understand the clinical implications of these findings.