Achilles Lengthening Procedures

作者：Chen Lan; Grei**erg Justin^*

来源：Foot and Ankle Clinics, 2009, 14(4): 627-637.

DOI：10.1016/j.fcl.2009.08.002

• Gastrocnemius recession
• Achilles contracture
• Equinus
• Achilles tendon
• Lengthening

Achilles contracture is a common finding and has been implicated in a number of pathologic conditions. The first step in dealing with the problem is in recognizing it. By studying comparative anatomy and evolutionary biology, it is easy to understand why gastrocnemius tightness is so prevalent. The physical examination must emphasize passive ankle dorsiflexion with the medial column reduced. Failure to achieve 10 degrees of dorsiflexion with the knee flexed and extended suggests a contracture.
Treatment begins with stretching and other nonsurgical options, but surgical lengthening should be considered in any case where progress deformity is possible. Some surgeons have even recommended surgical lengthening in high-risk patients (diabetics) as soon as the contracture is identified, even before clinical problems.

• 出版日期2009-12