Simone Moroni1, Alejandro Fernández-Gibello2, Gabriel Camunas Nieves3,4, Ruben Montes3,4, Marit Zwierzina5, Teresa Vazquez6, Maria Garcia-Escudero7, Fabrice Duparc8, Bernhard Moriggl9, Marko Konschake10. 1. Faculty of Health Sciences At Manresa, Department of Podiatry, Universidad de Vic-Universidad Central de Catalunya (UVic-Ucc), Clinic Vitruvio Biomecánica, BarcelonaMadrid, Spain. 2. Faculty of Health Sciences, Department of Podiatry, University of La Salle, Clinic Vitruvio Biomecánica, Madrid, Spain. 3. Universidad La Salle, Centro adscrito a la Universidad Autónoma de Madrid, Madrid, Spain. 4. Vitruvio Biomecanica Y Cirugia Clinic, Madrid, Spain. 5. Department of Plastic, Reconstructive and Aesthetic Surgery, Center of Operative Medicine, Medical University of Innsbruck (MUI), Innsbruck, Austria. 6. Anatomy and Embryology Department, School of Medicine, Complutense University of Madrid, Madrid, Spain. 7. School of Physiotherapy and Podiatry, University Catolica de Valencia, Valencia, Spain. 8. Laboratory of Anatomy, Faculty of Medicine, Rouen-Normandy University, Rouen, France. 9. Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University of Innsbruck (MUI), Müllerstr. 59, 6020, Innsbruck, Austria. 10. Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University of Innsbruck (MUI), Müllerstr. 59, 6020, Innsbruck, Austria. marko.konschake@i-med.ac.at.
Abstract
BACKGROUND: The surgical procedure itself of lengthening the gastrocnemius muscle aponeurosis is performed to treat multiple musculoskeletal, neurological and metabolical pathologies related to a gastro-soleus unit contracture such as plantar fasciitis, Achilles tendinopathy, metatarsalgia, cerebral palsy, or diabetic foot ulcerations. Therefore, the aim of our research was to prove the effectiveness and safety of a new ultrasound-guided surgery-technique for the lengthening of the anterior gastrocnemius muscle aponeurosis, the "GIAR"- technique: the gastrocnemius-intramuscular aponeurosis release. METHODS AND RESULTS: An ultrasound-guided surgical GIAR on ten fresh-frozen specimens (10 donors, 8 male, 2 females, 5 left and 5 right) was performed. Exclusion criteria of the donated bodies to science were BMI above 35 (impaired ultrasound echogenicity), signs of traumas in the ankle and crural region, a history of ankle or foot ischemic vascular disorder, surgery or space-occupying mass lesions. The surgical procedures were performed by two podiatric surgeons with more than 6 years of experience in ultrasound-guided procedures. The anterior gastrocnemius muscle aponeurosis was entirely transected in 10 over 10 specimens, with a mean portal length of 2 mm (± 1 mm). The mean gain at the ankle joint ROM after the GIAR was 7.9° (± 1.1°). No damages of important anatomical structures could be found. CONCLUSION: Results of this study indicate that our novel ultrasound-guided surgery for the lengthening of the anterior gastrocnemius muscle aponeurosis (GIAR) might be an effective and safe procedure.
BACKGROUND: The surgical procedure itself of lengthening the gastrocnemius muscle aponeurosis is performed to treat multiple musculoskeletal, neurological and metabolical pathologies related to a gastro-soleus unit contracture such as plantar fasciitis, Achilles tendinopathy, metatarsalgia, cerebral palsy, or diabetic foot ulcerations. Therefore, the aim of our research was to prove the effectiveness and safety of a new ultrasound-guided surgery-technique for the lengthening of the anterior gastrocnemius muscle aponeurosis, the "GIAR"- technique: the gastrocnemius-intramuscular aponeurosis release. METHODS AND RESULTS: An ultrasound-guided surgical GIAR on ten fresh-frozen specimens (10 donors, 8 male, 2 females, 5 left and 5 right) was performed. Exclusion criteria of the donated bodies to science were BMI above 35 (impaired ultrasound echogenicity), signs of traumas in the ankle and crural region, a history of ankle or foot ischemic vascular disorder, surgery or space-occupying mass lesions. The surgical procedures were performed by two podiatric surgeons with more than 6 years of experience in ultrasound-guided procedures. The anterior gastrocnemius muscle aponeurosis was entirely transected in 10 over 10 specimens, with a mean portal length of 2 mm (± 1 mm). The mean gain at the ankle joint ROM after the GIAR was 7.9° (± 1.1°). No damages of important anatomical structures could be found. CONCLUSION: Results of this study indicate that our novel ultrasound-guided surgery for the lengthening of the anterior gastrocnemius muscle aponeurosis (GIAR) might be an effective and safe procedure.
Authors: Simone Moroni; Javier Márquez; Alejandro Fernández-Gibello; Gabriel Camunas Nieves; Ruben Montes; Teresa Vázquez; José Ramon Sanudo; Bernhard Moriggl; Carla Stecco; R Shane Tubbs; Marko Konschake Journal: Sci Rep Date: 2022-03-21 Impact factor: 4.379