title: Severe equinus deformity after radiofrequency-induced calf muscle reduction.
abstract: BACKGROUND
  Radiofrequency-induced calf muscle volume reduction is a commonly used method for cosmetic shaping of the lower leg contour. Functional disabilities associated with the use of the radiofrequency (RF) technique, with this procedure targeting the normal gastrocnemius muscle, still have not been reported. However, the authors have experienced several severe ankle equinus cases after RF-induced calf muscle volume reduction.
  
  
  METHODS
  This study retrospectively reviewed 19 calves of 12 patients who showed more than 20° of fixed equinus even though they underwent physical therapy for more than 6 months. All were women with a mean age of 32 years (range, 23-41 years). Of the 12 patients, 7 were bilateral. All the patients received surgical Achilles lengthening for deformity correction. To evaluate the clinical outcome, serial ankle dorsiflexion was measured, and the American Orthopedic Foot and Ankle Society (AOFAS) score was evaluated at the latest follow-up visit. The presence of soleus muscle involvement and an ongoing lesion that might affect the postoperative results of preoperative magnetic resonance imaging (MRI) were investigated. Statistical analysis was conducted to analyze preoperative factors strongly associated with patient clinical outcomes.
  
  
  RESULTS
  The mean follow-up period after surgery was 18.6 months (range, 12-28 months). At the latest follow-up visit, the mean ankle dorsiflexion was 9° (range, 0-20°), and the mean AOFAS score was 87.7 (range, 80-98). On preoperative MRI, 13 calves showed soleus muscle involvement. Seven calves had ongoing lesions. Five of the ongoing lesions were muscle edema, and the remaining two lesions were cystic mass lesions resulting from muscle necrosis. Ankle dorsiflexion and AOFAS scores at the latest follow-up evaluation were insufficient in the ongoing lesions group.
  
  
  CONCLUSIONS
  Although RF-induced calf muscle reduction is believed to be a safer method than conventional procedures, careful handling is needed because of the side effects that may occur in some instances. The slow progression of fibrosis could be observed after RF-induced calf reduction. Therefore, long-term follow-up evaluation is needed after the procedure.
  
  
  METHODS
  Therapeutic case series.
authors: Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea.
authors: Kyung Sup
authors: KS
authors: Lim
authors: Jong Sup
authors: JS
authors: Shim
authors: Ki Sun
authors: KS
authors: Sung
authors: Kyung Hwan
authors: KH
authors: Koh
authors: Jung Hwan
authors: JH
authors: Kim
mesh_terms: D000328:Adult; D003357:Cosmetic Techniques; D004863:Equinus Deformity / Q000209:etiology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007866:Leg; D008279:Magnetic Resonance Imaging; D018482:Muscle, Skeletal / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult