27687 Gastrocnemius recession (eg, Strayer procedure)

Name of the Procedure:

Gastrocnemius Recession (Strayer Procedure)

Summary

Gastrocnemius recession, also known as the Strayer procedure, is a surgical technique designed to lengthen the gastrocnemius muscle in the calf. This muscle-lengthening procedure helps improve flexibility and alleviate conditions caused by tight calf muscles.

Purpose

The primary goal of gastrocnemius recession is to relieve tension in the calf muscles, which can lead to conditions such as chronic plantar fasciitis, Achilles tendonitis, and foot deformities. The procedure aims to restore a normal range of motion and reduce pain associated with these conditions.

Indications

• Chronic plantar fasciitis
• Achilles tendonitis
• Foot deformities involving tight calf muscles
• Limited ankle flexibility Patients who experience persistent pain, restricted movement, and unsuccessful outcomes from non-surgical treatments may be considered for the procedure.

Preparation

• Patients may need to fast for a certain period before the procedure if general anesthesia is used.
• Medications, especially blood thinners, may need to be adjusted according to medical advice.
• Preoperative assessments may include physical examinations, imaging studies (e.g., X-rays or MRIs), and consultations to ensure the patient is fit for surgery.

Procedure Description

1. The patient is positioned appropriately, and an area of the calf is cleaned and prepped with antiseptic.
2. Anesthesia is administered, which could be local, regional, or general, depending on patient and procedure specifics.
3. A small incision is made along the calf to expose the gastrocnemius muscle.
4. The muscle and its surrounding tissues are carefully dissected to allow lengthening.
5. The muscle is then adjusted to relieve tension, and the incision is closed with sutures.
6. A sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Gastrocnemius recession is usually performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon or podiatric surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses and technicians

Risks and Complications

• Infection
• Bleeding or hematoma
• Nerve damage
• Scarring
• Recurrence of muscle tightness
• Anesthesia-related risks

Benefits

Patients can expect improved calf flexibility, reduced tension, and relief from associated pain. Benefits are often noticeable within weeks after surgery but can continue to improve over several months.

Recovery

• Rest and limited weight-bearing on the affected leg are recommended for a specific period.
• Use of crutches, walking boots, or splints to facilitate healing.
• Physical therapy may be advised to enhance recovery and regain strength.
• Full recovery generally takes a few weeks to a few months, with gradual reintroduction to daily activities.

Alternatives

• Non-surgical treatments such as physical therapy, stretching exercises, orthotics, and anti-inflammatory medications.
• Corticosteroid injections
• Pros: Less invasive, lower risks, shorter recovery time.
• Cons: May not provide lasting relief, especially if conservative treatments have been exhausted.

Patient Experience

Patients may feel slight discomfort or soreness after the procedure, but pain is generally manageable with prescribed medications. Initially, there may be some swelling and limited mobility, but these symptoms subside with proper care. Physical therapy and following postoperative instructions facilitate a smooth recovery.