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Ultrasound-guided minimally invasive release of the proximal medial gastrocnemius: A cadaveric study
Jeffrey Michaud1, Lolita Micicoi2, Olivier Marès1
1Orthopedic and Traumatology Surgery Department, CHU Nîmes, University Montpellier I, Nîmes, Place du Professeur Robert Debré, 30029 Nîmes, France.
Background:
Posterior chain contractures contribute to functional impairment in foot and ankle disorders. Open gastrocnemius lengthening techniques are effective but invasive and associated with soft tissue morbidity. Ultrasound-guided percutaneous aponeurotic release represents a minimally invasive alternative. This study aimed to assess the feasibility, safety, and efficacy of an ultrasound-guided, single-operator medial gastrocnemius aponeurosis release technique.
Methods:
Six fresh-frozen cadavers (12 lower limbs) underwent ultrasound-guided proximal medial gastrocnemius aponeurosis release using a minimally invasive single operator technique. The extent of aponeurosis sectioning was categorized, and operative time, peri-procedural complications, and changes in ankle dorsiflexion were assessed.
Results:
More than 75% aponeurosis sectioning was achieved in 83% of cases (10/12). No neurovascular injuries were identified. Ankle dorsiflexion increased significantly from 9.7° ± 1.97 to 20.5° ± 4.59, mean gain 10.8°± 2.86 (p < 0.001).
Conclusions:
This ultrasound-guided technique appears safe and effective. Clinical studies are warranted to confirm its applicability in vivo.
Level Of Evidence:
IV; experimental study.
