The Use of Ultrasound to Isolate the Gastrocnemius-Soleus Junction Prior to Gastrocnemius Recession

Gastrocnemius recession is a popular procedure to release isolated calf tightness, a recognized contributor to forefoot overload, plantar fasciitis, flatfoot and foot pain. But planning the incision by visual landmarks alone can be deceiving: calf shapes vary so much that the incision may be off by several centimeters, and cutting the underlying soleus effectively converts the operation into an Achilles lengthening. In this episode we review the technique described by Toomey and Seibert: a quick preoperative ultrasound scan, done in the holding area with the same machine used for nerve blocks, that reproducibly locates the gastrocnemius-soleus junction and allows a smaller, precisely placed incision with an isolated release of the gastrocnemius fascia. We also cover the supporting outcome data from cited series: pain scores improving from 8/10 to 2/10 with 93 percent satisfaction, peak torque recovering to 74 percent of the opposite limb by 18 months, and a 6 percent adverse event rate across 126 cases with all patients achieving a single limb heel rise at 6 months. The Use of Ultrasound to Isolate the Gastrocnemius-Soleus Junction Prior to Gastrocnemius RecessionToomey EP, Seibert NR · Foot and Ankle Clinics of North America, 2014https://doi.org/10.1016/j.fcl.2014.08.008 Want our summary slides for every paper? Follow us on Instagram: @dr.polotrauma