Proximal Medial Gastrocnemius Release: Surgical Technique
Carlo Gamba1,2, Carlos Álvarez Gomez1, Judit Martínez Zaragoza1
1Hospital de la Santa Creu I Sant Pau, Universitat Autonoma Barcelona, Barcelona, Spain.
JBJS Essential Surgical Techniques
|June 13, 2022
Summary
Proximal medial gastrocnemius release (PMGR) effectively treats recalcitrant plantar fasciitis and other conditions by relieving tension in the lower leg. This safe and easy surgical technique offers rapid recovery and good results for patients.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanical Engineering
Background:
- Biomechanical overload in the Achilles-calcaneus-plantar system can cause conditions like recalcitrant plantar fasciitis.
- Nonoperative treatments are the first line of defense but may not resolve persistent symptoms.
Purpose of the Study:
- To describe the technique and outcomes of Proximal Medial Gastrocnemius Release (PMGR).
- To evaluate PMGR as a safe and effective surgical option for specific lower extremity conditions.
Main Methods:
- PMGR involves a posteromedial incision below the knee crease to release the proximal insertion of the medial gastrocnemius.
- The procedure is performed in a prone position, with careful sectioning of white fibers and completed by ankle dorsiflexion.
Main Results:
- PMGR demonstrates a patient satisfaction rate of over 80% with substantial pain relief within 2-3 months.
- The procedure is associated with a low complication rate, primarily calf hematomas and delayed wound healing.
Conclusions:
- PMGR is an effective, safe, and minimally invasive surgical technique for recalcitrant plantar fasciitis and other gastrocnemius-related issues.
- It offers rapid recovery, good functional outcomes, and improved quality of life compared to other surgical interventions.
