Anatomic study and clinical effect of the selective neurotomy of medial and lateral heads of muscular branches to gastrocnemius on calf reducetion

Objective:To explore the possibility of reducing the volume of gastrocnemius muscle for calf reduction by neurotomy of the nerve to medial and lateral heads of the gastrocnemius muscle. Methods:Neurotomy of the nerve to medial and lateral heads of the gastrocnemius muscle was performed in 9 cases(18 side). The origining points of medial and lateral branches from tibial nerve and their relationship with other nerves was observed. The circumference and the shape of the calf were measured and observed. Results:(1)Branches to the medial and lateral heads of gastrocnemius arised from the tibial nerve, at a limited region no more than 1.5cm around the centre of the popliteal fossa.(2)The medial and lateral branches firmly related with the muscular branches reaching to soleus and the medial sural cutaneous nerve, which shown that it could be more safety to cut them where the branches entered into the hilums of the heads of the gastrocnemius muscle.(3)Neurotomy of the nerve to medial and lateral heads of the gastrocnemius muscle was performed in 9 cases. After operation, the circumference of the leg reduced about(4.2±1.2)cm averagely and the curve of the calf reduced too. There was no obvious swelling in all cases and patients can walk immediately after operation. The function of the leg was not obviously influenced according the following up data from 3 months to 1 year. Conclusions:(1)Neurotomy of the nerve to medial and lateral heads of gastrocnemius muscle could reduce the volume of gastrocnemius muscle.(2)This method is safe and simple,and do not effect walking function of patients.