Gastrocnemius recession leads to medial shift of gait line, impairment of muscle strength and improved dorsal extension in forefoot overload syndrome. Issue 4 (August 2018)

• Record Type: Journal Article
• Authors: Schmal, Hagen; Walther, Markus; Hirschmüller, Anja; Bunert, Nina; Südkamp, Norbert P.; Mehlhorn, Alexander T.
• Is Part Of: Foot and ankle surgery. Volume 24:Issue 4(2018)
• Page Start: 309
• Page End: 313
• Publication Date: 2018-08
• Subjects: Gastrocnemius tightness -- Gastrocnemius recession -- Forefoot overload syndrome -- Muscle strength; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2017.03.014
• Languages: English
• ISSNs: 1268-7731

Abstract

Highlights: After gastrocnemius recession (GR) plantarflexors are impaired about 40% at 6 weeks. Plantarflexors regain power up to 90% at 24 weeks after GR. GR leads to pain relief in patients with forefoot overload syndrome. Pedobarography shows an increased contact time of the heel after GR. Pedobarography demonstrates a shift of plantar peak pressure from lateral to medial. Abstract: Background: Gastrocnemius recession (GR) has been introduced for treatment of forefoot overload syndrome (FOS). We questioned if GR leads to an altered forefoot load and weakness of plantarflexors in those patients. Methods: 26 patients suffering from FOS and gastrocnemius tightness underwent GR. A strength power analysis of plantar flexors and a pedobarography was performed. Clinical outcome was measured by Foot Function Index (FFI). Results: Plantarflexors are impaired about 40% six weeks and around 10% 24 weeks following GR compared to the contralateral side. Patients experienced a pain relief and an improvement of ankle dorsiflexion from 2° to 15°. An increased contact time of the heel (15%) and a shift of metatarsal plantar pressure from lateral to medial could be demonstrated. Conclusions: This study suggests that GR leads to pain reduction by an increase in heel contact time and a shift of gait line to medial in patients with a FOS. Despite, a temporary impairment of muscle strength has to be considered.