Foot Ankle Int. 2009 Dec;30(12):1202-6. doi: 10.3113/FAI.2009.1202.
The importance of isolated gastrocnemius contracture in disorders of the foot and ankle has been established in recent years. The aim of this study was to describe the proximal anatomical approach to the medial and lateral heads of gastrocnemius and to compare the sizes of the medial and lateral heads of the gastrocnemius.
15 cadaveric extremities were dissected using a posterior approach 1 cm below the level of the skin crease. Proximity of cutaneous nerves and major vessels was noted. The heads of the gastrocnemius were dissected from their origin and the cross sectional anatomy was assessed.
Approach to the medial head of gastrocnemius was safe. Conversely the variable anatomy of the nerves in the approach to the lateral head meant that extreme care must be taken if complications are to be avoided. The aponeurosis of the medial head of gastrocnemius was 2.4 times the cross-sectional area compared to the lateral head.
In this study we describe a safe posterior approach to the medial aponeurosis of the gastrocnemius and also describe the different sizes of the medial and lateral gastrocnemius heads.
We conclude that the approach to the medial head of gastrocnemius is free from neurovascular structures and that release of the medial head alone may be efficacious in the operative treatment of isolated gastrocnemius tightness that has failed non-operative treatment.
近年来，孤立性比目鱼肌挛缩在足踝疾病中的重要性已得到证实。本研究旨在描述比目鱼肌内侧和外侧头的近端解剖入路，并比较比目鱼肌内侧和外侧头的大小。
15 具尸体下肢采用皮肤皱褶下 1cm 处的后入路进行解剖。注意皮肤神经和主要血管的临近关系。从起点解剖比目鱼肌头，并评估其横断解剖结构。
比目鱼肌内侧头的入路是安全的。相比之下，外侧头神经的解剖结构多变，如果要避免并发症，就必须格外小心。比目鱼肌内侧头的腱膜横截面积是外侧头的 2.4 倍。
在这项研究中，我们描述了一种安全的比目鱼肌内侧腱膜的后入路，还描述了比目鱼肌内侧和外侧头的不同大小。
我们得出结论，比目鱼肌内侧头的入路没有神经血管结构，单独松解内侧头可能对非手术治疗失败的孤立性比目鱼肌紧张有效。
