Gastrocnemius Lengthening and Partial Neurotomy

Gastrocnemius extension and partial neurotomy for the surgical treatment of clubfoot. Treatment of diseases: congenital clubfoot Indication Gastrocnemius extension and partial neurotomy are suitable for patients with mild clubfoot deformity and need to do hamstring tendon extension for the treatment of knee flexion contracture. Preoperative preparation Regular preoperative examination. Surgical procedure 1. The sick child takes the prone position, general anesthesia, the use of a tourniquet, and a transverse incision parallel to the skin folds in the armpit. It starts from 1cm outside the biceps tendon and ends at 1cm inside the semitendinosus tendon. Cut the skin, subcutaneous, deep fascia, and expose the two starting points of the gastrocnemius. If it is necessary to cut off the nerve, confirm the phrenic nerve, and free the branch that supports the two ends of the gastrocnemius. Usually 1 or 2 branches from the phrenic nerve obliquely downward to the medial head or lateral head of the gastrocnemius muscle, carefully holding these branches for further determination, and then removing a branch of the nerve to lose half or more of the nerves at both ends. The iliac vein is located deep in the phrenic nerve, taking care to avoid damage to the vein. 2. Use the bending forceps to lift the two heads of the gastrocnemius muscle, cut it off near the attachment point, and free it from the back of the femoral condyle. At this time, care should be taken to protect the phrenic nerve near the lateral head, and then the both sides of the head are bluntly separated by gauze and released to the distal end of the knee joint. The wound is closed routinely.