title: Ankle Plantar-Flexion Contracture Complication After Aesthetic Calf Volume Reduction Procedure.
abstract: Minimally invasive, aesthetic calf volume reduction procedures are considered to be relatively safe. Published complications are mostly transient, with minimal functional loss. We hereby report debilitating ankle plantar-flexion contracture after aesthetic calf volume reduction procedure by selective neurectomy, with magnetic resonance imaging analysis and surgical treatment outcomes of this complication. From 2009 to 2010, 11 patients (17 lower legs) were surgically treated for this complication. The average preoperative ankle contracture angle of all involved lower legs was -22 degrees (range, -5 to -30 degrees). Magnetic resonance imaging performed in 14 lower legs showed lesions indicative of denervation atrophy, with fibrotic lesions causing longitudinal shortening of the gastrocnemius muscle. Of the 17 ankle contractures, 15 Silfverskiöld test-positive cases received miniopen gastrocnemius release, whereas 2 Silfverskiöld test-negative cases received Achilles tendon lengthening by percutaneous triple hemiresection. At last follow-up, the dorsiflexion angle of all ankles improved to an average of 25 degrees (range, 20-30 degrees) with full plantar flexion in all patients, whereas the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale scores improved from an average of 59.2 to 94.2. Surgeons and patients alike should be aware of debilitating ankle planter flexion contractures after aesthetic calf volume reduction procedures. Using minimally invasive gastrocnemius and Achilles tendon release, we were able to provide symptomatic and functional relief from this complication with minimal cosmetic sacrifice.
authors.affiliation: From the *Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul; Departments of †Orthopedic Surgery, and ‡Anatomy, Ajou University School of Medicine, Suwon, Kyounggi-do, South Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Han
authors.forename: Nam Su
authors.initials: NS
authors.lastname: Chung
authors.forename: Do Young
authors.initials: DY
authors.lastname: Park
mesh_terms: D000328:Adult; D000843:Ankle Joint; D003286:Contracture / Q000209:etiology*; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D055815:Young Adult