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Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture

BACKGROUND: Diabetic equinus secondary to gastrocnemius contracture is a known predominant risk factor in diabetic foot ulceration characterized by reduction of ankle dorsiflexion. Recession surgery involves release of the gastrocnemius muscle at its aponeurosis and is one of the treatments of cho...

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Main Author: Gill, Narinder Singh
Format: Thesis
Language:English
Published: 2014
Subjects:
RD701-811 Orthopedic surgery
Online Access:http://eprints.usm.my/39580/1/Dr._Narinder_Singh_al_Joginder_Singh_%28_Orthopaedic_Surgery_%29-24_pages.pdf
http://eprints.usm.my/39580/
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spelling my.usm.eprints.39580 http://eprints.usm.my/39580/ Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture Gill, Narinder Singh RD701-811 Orthopedic surgery BACKGROUND: Diabetic equinus secondary to gastrocnemius contracture is a known predominant risk factor in diabetic foot ulceration characterized by reduction of ankle dorsiflexion. Recession surgery involves release of the gastrocnemius muscle at its aponeurosis and is one of the treatments of choice in improvement of diabetic equinus contracture. OBJECTIVE: To measure degree of improvement of ankle dorsiflexion and length gained at gastrocnemius aponeurosis following gastrocnemius recession surgery in diabetic equinus contracture. To assess correlation between the lengths gained at gastrocnemius aponeurosis with degrees of improvement in ankle dorsiflexion following surgery. METHODOLOGY: Total of 76 patients was recruited in the Orthopaedic clinics and wards at Penang General Hospital. Presence of gastrocnemius equinus was established with a positive Silfverskiold test. Gastrocnemius recession surgery using the Modified Strayer Technique was done following failed conservative therapy. Pre and post-operative ankle dorsiflexion was measured. Length gained at gastrocnemius aponeurosis was measured at 6 weeks post-operative using Ultrasound done in maximal ankle dorsiflexion. Results were analyzed using SPSS version 20.0 RESULTS: The severity of equinus contracture did not correlate to chronicity of diabetes mellitus. There was improvement of ankle dorsiflexion seen at 6 weeks post-operatively. It ranged from 6 to 16 degrees and was coupled with statistical significant length gained at gastrocnemius aponeurosis that ranged from a mean of 0.8cm to 3.8cm. Mean improvement ofankle dorsiflexion was 11.05 degrees. Mean improvement of length gain at gastrocnemius aponeurosis was 1.54cm. CONCLUSION: Gastrocnemius recession surgery appropriately addresses diabetic equinus secondary to gastrocnemius contractures by improving ankle dorsiflexion and is evidenced by a significant increase in length at the aponeurosis. 2014 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/39580/1/Dr._Narinder_Singh_al_Joginder_Singh_%28_Orthopaedic_Surgery_%29-24_pages.pdf Gill, Narinder Singh (2014) Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture. Masters thesis, Universiti Sains Malaysia.
institution Universiti Sains Malaysia
building Hamzah Sendut Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Sains Malaysia
content_source USM Institutional Repository
url_provider http://eprints.usm.my/
language English
topic RD701-811 Orthopedic surgery
spellingShingle RD701-811 Orthopedic surgery
Gill, Narinder Singh
Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture
description BACKGROUND: Diabetic equinus secondary to gastrocnemius contracture is a known predominant risk factor in diabetic foot ulceration characterized by reduction of ankle dorsiflexion. Recession surgery involves release of the gastrocnemius muscle at its aponeurosis and is one of the treatments of choice in improvement of diabetic equinus contracture. OBJECTIVE: To measure degree of improvement of ankle dorsiflexion and length gained at gastrocnemius aponeurosis following gastrocnemius recession surgery in diabetic equinus contracture. To assess correlation between the lengths gained at gastrocnemius aponeurosis with degrees of improvement in ankle dorsiflexion following surgery. METHODOLOGY: Total of 76 patients was recruited in the Orthopaedic clinics and wards at Penang General Hospital. Presence of gastrocnemius equinus was established with a positive Silfverskiold test. Gastrocnemius recession surgery using the Modified Strayer Technique was done following failed conservative therapy. Pre and post-operative ankle dorsiflexion was measured. Length gained at gastrocnemius aponeurosis was measured at 6 weeks post-operative using Ultrasound done in maximal ankle dorsiflexion. Results were analyzed using SPSS version 20.0 RESULTS: The severity of equinus contracture did not correlate to chronicity of diabetes mellitus. There was improvement of ankle dorsiflexion seen at 6 weeks post-operatively. It ranged from 6 to 16 degrees and was coupled with statistical significant length gained at gastrocnemius aponeurosis that ranged from a mean of 0.8cm to 3.8cm. Mean improvement ofankle dorsiflexion was 11.05 degrees. Mean improvement of length gain at gastrocnemius aponeurosis was 1.54cm. CONCLUSION: Gastrocnemius recession surgery appropriately addresses diabetic equinus secondary to gastrocnemius contractures by improving ankle dorsiflexion and is evidenced by a significant increase in length at the aponeurosis.
format Thesis
author Gill, Narinder Singh
author_facet Gill, Narinder Singh
author_sort Gill, Narinder Singh
title Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture
title_short Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture
title_full Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture
title_fullStr Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture
title_full_unstemmed Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture
title_sort study on outcome of gastrocnemius recession surgery in diabetic equinus contracture
publishDate 2014
url http://eprints.usm.my/39580/1/Dr._Narinder_Singh_al_Joginder_Singh_%28_Orthopaedic_Surgery_%29-24_pages.pdf
http://eprints.usm.my/39580/
_version_ 1643709692582559744
score 13.211869

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