Endoscopic Layered Adhesiolysis of Gastrocsoleus Muscles

Fibrous adhesions of the gastrocsoleus muscles can occur after trauma. The necrotic part of the muscle can become fibrotic and adhere to the surrounding structures. In case of tibial or fibular fracture, the muscles and their enveloping fascia can adhere to the bones by scar tissue. Immobilization of the fibrotic portion during the post-traumatic period can further reduce muscle and tendon mobility. Adhesions can occur between the gastrocnemius muscle and deep fascia of the leg, between the gastrocnemius and soleus muscles, and between the soleus and deep posterior compartment of the leg. The purpose of this technical note is to describe the details of endoscopic layered adhesiolysis of the gastrocsoleus muscles. This minimally invasive approach allows adequate release of every plane of the gastrocsoleus muscles and immediate vigorous mobilization of the foot and ankle.