Cadaveric Endoscopic Gastrocnemius Recession Procedures to Identify Vital Anatomical Structures and Limit Intraoperative and Post-Operative Complications

Gastrocnemius equinus contracture plays a role in a multitude of patient pathologies, conditions, and deformities seen in podiatric medicine (Barrett, 2011). Equinus deformity is associated with over 96% of the biomechanically-related foot and ankle pathologies including hallux valgus, metatarsalgia, capsulitis, pes planus, plantar fasciitis, tendonitis, and others (Deheer, 2015). These pathologies are linked with a decreased range of motion in the ankle joint specifically in dorsiflexion. Corrective approaches can be taken to reduce pathology if the patient presents prior to any major deformity. The aim of this study is to better define the location of the small saphenous vein and sural nerve in relation to the cannula, in order to decrease intra- operative injury to these structures during the endoscopic surgical approach using 10 cadaveric specimens. It was observed that the sural nerve was on average 4.71 cm from the medial aspect of the cannula with a range of 3.1 cm to 6.0 cm. The small saphenous vein was observed approximately 4.06 cm on average from the medial cannula with a range of 2.5 cm to 5.0 cm. With an increased understanding of the distance between the sural nerve and small saphenous vein compared to the surgical site, the potential for risk and injury may continue to decrease