Schmal Hagen, Walther Markus, Hirschmüller Anja, Bunert Nina, Südkamp Norbert P, Mehlhorn Alexander T
Department of Orthopedic and Trauma Surgery, University Medical Center, Hugstetterstraße 55, 79106, Freiburg, Germany; Department of Orthopedics and Traumatology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, 500, Odense C, Denmark.
Center of Foot and Ankle Surgery, Schön Klinik München Harlaching, Harlachingerstraße 51, 81547, Munich, Germany.
Foot Ankle Surg. 2018 Aug;24(4):309-313. doi: 10.1016/j.fas.2017.03.014. Epub 2017 Apr 4.
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.
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).
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.
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.
