The effect of gastrocnemius tightness on the pathogenesis of juvenile hallux valgus: a preliminary study.

Hallux valgus is the most common foot disorder associated with gastrocnemius tightness, and there is a particularly strong association with juvenile hallux valgus. This article describes an oblique windlass mechanism that can be a causative or a contributory factor in the pathogenesis of juvenile hallux valgus. This article presents a study of 108 patients who underwent a proximal gastrocnemius release and hallux valgus correction using a scarf osteotomy.

Clinical diagnosis of gastrocnemius tightness.

The diagnosis of gastrocnemius tightness is primarily clinical using the Silfverskiold test, which shows an equinus deformity at the ankle with the knee extended but that disappears with the knee flexed. The manner in which the Silfverskiold test is performed must be consistent with respect to the applied strength of the maneuver, correction of a flexible hindfoot valgus deformity while performing the test, and reproducibility. Although this is a diagnosis based on the clinical examination, this article presents additional clinical signs that can help to make the diagnosis when the retraction is not clinically evident.