Achilles lengthening procedures.
Contracture of the gastrocnemius-soleus complex with equinus deformity is a common hindfoot condition. In children, it is frequently associated with neuromuscular conditions such as cerebral palsy. In the adult population, it is linked to numerous pathologies such as adult-acquired flatfoot, diabetic neuropathic ulcers, and plantar fasciitis. With the medial column reduced, failure to achieve 10 degrees of passive ankle dorsiflexion with the knee flexed and extended suggests a contracture. This article reviews the anatomical and evolutionary basis for human foot structure, implications of tight gastrocnemius, and specific disease states. Operative releases for lengthening, including proximal gastrocnemius recession, tendo-Achilles lengthening, and endoscopic recession, are detailed.
Chen
Lan
L
Department of Orthopedic Surgery, Columbia University Medical Center, 622 West 168th Street, PH11-Center, New York, NY 10032, USA.
Greisberg
Justin
J
D000125:Achilles Tendon / Q000601:surgery*; D000328:Adult; D003286:Contracture / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D017719:Diabetic Foot / Q000453:epidemiology / Q000601:surgery; D004724:Endoscopy; D036981:Fasciitis, Plantar / Q000453:epidemiology; D005413:Flatfoot / Q000503:physiopathology; D005684:Gait / Q000502:physiology; D006801:Humans; D009119:Muscle Contraction / Q000502:physiology; D019637:Orthopedic Procedures