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
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spelling	my-usm-ep.395802019-04-12T05:26:04Z Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture 2014 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 http://eprints.usm.my/39580/ http://eprints.usm.my/39580/1/Dr._Narinder_Singh_al_Joginder_Singh_%28_Orthopaedic_Surgery_%29-24_pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
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
qualification_level	Master's degree
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
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2014
url	http://eprints.usm.my/39580/1/Dr._Narinder_Singh_al_Joginder_Singh_%28_Orthopaedic_Surgery_%29-24_pages.pdf
_version_	1747820760612732928

Study on outcome of gastrocnemius recession surgery in diabetic equinus contracture

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