ABSTRACT
Gastrocnemius recession has become a popular procedure to release isolated gastrocnemius tightness. Using visual anatomic landmarks alone to plan the incision can be deceiving. The use of ultrasound preoperatively has been highly reproducible in isolating the gastrocnemius-soleus junction in the authors' practice. This provides confidence for incision placement, a smaller incision, and isolated release of the gastrocnemius fascia while leaving the underlying soleus undisturbed.
Subject(s)
Achilles Tendon/diagnostic imaging , Contracture/surgery , Muscle, Skeletal/diagnostic imaging , Anatomic Landmarks , Contracture/diagnostic imaging , Humans , Muscle, Skeletal/physiopathology , Muscle, Skeletal/surgery , UltrasonographyABSTRACT
Cheilectomy has long been the standard treatment in the orthopedic community for mild to moderate cases of hallux rigidus, with established long-term excellent results. Osteotomies of the proximal phalanx and first metatarsal have been described mainly in the podiatric literature; they have shown good outcomes in small patient groups with short-term follow-up. Proper patient selection is critical to obtaining favorable outcomes with any of the joint-sparing procedures. Patients with severe arthritic changes and pain in the midrange arc of motion have poorer outcomes with these procedures and are better served with joint-destructive procedures, such as arthroplasty or arthrodesis.
