Jeffrey K. Anhalt, D.O.J. Christopher Eyke, M.D.Daniel J. Fett, D.O.Yousif I. Hamati, M.D.,F.A.C.S.Jack W. Heethouse, D.O.Reginald W. Kapteyn, D.O.Fredric D. Levin, D.O.Mark J.R. Moulton, M.D.Richard E. Moulton, M.D.Martin M. Pallante, M.D.Aaron D. Potts, M.D.Jeffrey D. Recknagel, M.D.Anthony Wilson, M.D.

1400 Mercy Drive, Ste 100Muskegon, MI 49444231 733-1326 phone231 733-5212 fax

www.oamkg.com

Gastrocnemius Slide Surgery

When is it Time to Think AboutSurgery?

A gastrocnemius slide surgery isindicated for patients who have acontracture (tightness) in their outer calfmuscle (the gastrocnemius), and havefailed non-operative management. Oftena regular calf stretching program and useof orthotic devices in your shoes canlead to successful non-operativemanagement of symptoms. However, insome instances surgical treatment isindicated. Gastrocnemius contractureresults in the inability to bring the anklejoint past a neutral position (right angleto the lower leg) with the knee straight.Rather than “walk on their toes” mostpeople naturally and unconsciously“compensate” by having more motionthrough the joints in front of the ankle.This midfoot compensation often leadsto increased repetitive pressure tovarious structures in the foot duringstanding and walking. Therefore, thepresence of a contracture may lead topainful conditions of the foot.

About the Surgery

The outpatient procedure takesapproximately one hour and isperformed under general anesthesia. Asmall incision (approximately 1/2 inch)is made on the inside area of the lowerleg and the gastrocnemius tendon isexposed. Several tiny rows of incisions ora single incision is made across thetendon to allow it to stretch andlengthen. Patients will now have thesame ankle motion with their kneestraight that they previously had withtheir knee bent. The skin incision issutured closed and a dressing is applied.

Preparing for Surgery

Pre-admission testing may be donebefore your surgery to ensure that youare healthy enough for the plannedprocedure. Testing may include lab work,an EKG and a chest x-ray. You areencouraged to stop smoking beforesurgery to prevent lung complications ordelayed healing. Please bring yoursurgical boot to surgery. Anti-inflammatory medications, aspirin andblood-thinning medications should bestopped one week before your surgeryunless otherwise specified by your familydoctor. These medications affect yourblood clotting ability and could increaseyour risk for bleeding.

What to Expect After Surgery

Please wear the surgical boot when youwalk until you are seen for your firstpost-op appointment. The boot may beremoved for hygiene purposes only forthe first two weeks. The dressing overthe incision may be removed after 48hours and you may shower. Do notsubmerge your leg in water until theincision is healed and free of any scabs.Do not apply any lotions or antibioticointments to the incision. Keep the

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Gastrocnemius Slide Surgery [page 2]

incision covered with clean dry gauze until you are seenin your doctor’s office 3 weeks after surgery. Your sutureswill be removed at that appointment. You must wearyour boot while sleeping for the first two weeks aftersurgery.

Complications and Risks of Surgery

Blood clots: Symptoms of a blood clot include pain,swelling or redness of your calf or thigh. Call the officeimmediately if you develop any of these symptoms orgo to the Emergency Room. If you develop suddenshortness of breath go to the nearest Emergency Roomor call 911. Walk every hour during the daytime.Patients who are immobile for prolonged periods oftime are at a higher risk of blood clots.

Infection: Infection is rare but can occur followingsurgery. You are at a higher risk for infection if you havediabetes, rheumatoid arthritis, chronic liver or kidneydisease or if you are taking steroids. Symptoms include:fever or chills, drainage, redness, foul smell or increasedpain at the incision sites. Call the office immediately ifany of these symptoms occur.

Anesthesia complications: Respiratory failure, shock,cardiac arrest, and death are always possible duringsurgery. Patients with long-term kidney, heart, liver, orlung disease are at a higher risk. Nausea and vomitingfrom the anesthesia can be common. Coughing, deepbreathing exercises, and drinking plenty of fluids willhelp to flush out the anesthesia gases.

Nerve damage: The sural nerve runs along the top ofthe muscle being lengthened (the gastrocnemius).Although uncommon, injury or irritation of the suralnerve may lead to pain and/or numbness around theoutside of the foot. Notify your surgeon if numbness ortingling is prolonged or worsens after surgery.

Tethering of the skin: The skin incision may adhere tothe tissue overlying the calf muscle. This can causetethering of the skin when the calf muscle moves. Yourdoctor may instruct you in deep massage to this area tobreak up these adhesions.

Calf weakness: Some initial calf weakness occurs in allpatients. This weakness typically resolves within 6-9months of surgery.

Recovery Period

The average recovery period is approximately 6 weeks.Patients may be allowed to return to a sedentary jobwithin a few days after surgery. Patients with laborintensive jobs that require prolonged standing orsquatting/kneeling or stair/ladder climbing may not beable to return to work for approximately 8 weeks or mayreturn sooner with restrictions on these types ofactivities. You may not drive for 3 weeks if your surgerywas on the right side.

REVISED 8/5/14