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Related Experiment Video

Updated: Jun 30, 2026

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Proximal vs Distal Gastrocnemius Recession: Randomized Side-to-Side Comparison in Full-Body Cadaveric Specimens.

Michael Michlin1, Leda Kovatsi2, Ophir Freund3

  • 1St Luke's Hospital, Panorama, Thessaloniki, Greece.

Foot & Ankle International
|November 29, 2025
PubMed
Summary
This summary is machine-generated.

The Strayer procedure (SP) offers significantly greater ankle dorsiflexion gain compared to proximal medial gastrocnemius release (PMGR). This study found SP provided more absolute and relative dorsiflexion increase in cadavers.

Keywords:
PMGRStrayercadavericcomparative studygastrocnemius recessiongastrocnemius tightness

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Area of Science:

  • Orthopaedic Surgery
  • Biomechanics
  • Anatomy

Background:

  • Gastrocnemius tightness is a common cause of foot and ankle issues.
  • Proximal medial gastrocnemius release (PMGR) and the Strayer procedure (SP) are common treatments, but comparative biomechanical data are limited.
  • Cadaveric studies are crucial for understanding surgical effects on biomechanics.

Purpose of the Study:

  • To compare the biomechanical effects of PMGR and SP on ankle dorsiflexion (DF).
  • To evaluate the increase in passive ankle DF achieved by each procedure within the same cadaveric specimen.
  • To determine if the level of gastrocnemius release impacts the extent of DF correction.

Main Methods:

  • Fifteen non-embalmed cadaveric specimens were used for a side-to-side comparison.
  • One leg of each specimen underwent PMGR, and the contralateral leg underwent SP.
  • Passive ankle DF was measured pre- and post-surgery under a 10-kg load by a masked observer using an electronic goniometer.

Main Results:

  • Both procedures were performed by a single surgeon; measurements were masked.
  • Baseline DF was comparable between limbs (PMGR: -18.5°, SP: -19.0°).
  • The SP yielded significantly greater DF increase (median 14.7° absolute, 14.9% relative) compared to PMGR (median 8.0° absolute, 7.4% relative) (P < .001 for both).

Conclusions:

  • The distal Strayer procedure provides significantly greater ankle dorsiflexion gain than proximal medial gastrocnemius release.
  • The extent of correction is influenced by the level of gastrocnemius recession.
  • Clinical decisions should weigh the demonstrated biomechanical differences against the procedural risks of each technique.