Results of proximal medial gastrocnemius release for Achilles tendinopathy.

Background: Most patients with Achilles tendinopathy (AT) are treated successfully with physiotherapy involving eccentric calf training. In some patients, gastrocnemius contracture persists and there are reports of improvement following gastrocnemius release. We present the first series of patients to have proximal medial gastrocnemius release (PMGR) for AT.

Proximal medial gastrocnemius release in the treatment of recalcitrant plantar fasciitis.

Background: Isolated gastrocnemius contracture has been implicated as the cause of a number of foot and ankle conditions. Plantar fasciitis (PF) is one such condition that can be secondary to altered foot biomechanics as a result of gastrocnemius contracture. In this paper, we report our results with an isolated release of the proximal medial head of gastrocnemius for recalcitrant PF.

Idiopathic toe walking and contractures of the triceps surae.

Toe walking is a common feature in immature gait and is considered normal up to 3 years of age. As walking ability improves, initial contact is made with the heel. Toe-walkers will stand out as different once heel-strike is achieved by most of their peers.

The prevalence of symptomatic posterior tibialis tendon dysfunction in women over the age of 40 in England.

Background: To investigate the prevalence of posterior tibial tendon dysfunction (PTTD) in women over the age of 40.

Methods: A validated survey was posted to a random sample of 1000 women (over 40 years) from a GP group practice in Hertfordshire, England. Survey positive women were telephoned and when indicated, a detailed examination was performed.

Teaching cognitive skills improves learning in surgical skills courses: a blinded, prospective, randomized study.

Objective: To investigate the teaching of cognitive skills within a technical skills course, we carried out a blinded, randomized prospective study.

Methods: Twenty-one junior residents (postgraduate years 1-3) from a single program at a surgical-skills training centre were randomized to 2 surgical skills courses teaching total knee arthroplasty. One course taught only technical skill and had more repetitions of the task (5 or 6).

Avulsion fracture of the extensor carpi radialis brevis insertion.

Avulsion of the extensor carpi radialis brevis at wrist level is rare. We present a case of an avulsion fracture involving the extensor carpi radialis brevis insertion at the base of the middle finger metacarpal.

Tibialis posterior insufficiency occurring in a patient without peronei: a mechanical etiology.

A patient presented with a painful flatfoot deformity, which developed after the onset of a drop-foot secondary to a herniated lumbar disk. On examination, the only functioning muscles were her gastrocnemius-soleus complex and her intrinsic toe flexors. Her affected foot had taken the classic deformity seen with tibialis posterior dysfunction--a valgus heel, midfoot collapse and an abducted forefoot.