Hidrodisección ecoguiada selectiva de rama nerviosa gemelar tras atrapamiento posquirúrgico: a propósito de un caso / Selective ultrasound-guided hydrodissection of gastrocnemius nerve branch after post-surgical entrapment: apropos of a case

La fasciosis plantar crónica o recalcitrante es una causa de dolor plantar persistente. Estos casos suelen ser resistentes a los tratamientos convencionales de ejercicios, ortesis, ondas de choque e infiltraciones, requiriendo un abordaje quirúrgico. Entre las opciones quirúrgicas se encuentra la liberación proximal del gemelo medial como una alternativa con resultados satisfactorios, pero este procedimiento no está exento de complicaciones, pudiendo producir lesiones o atrapamientos nerviosos, entre otras. Describimos el primer caso publicado de atrapamiento de la rama gemelar medial, sintomático, en el seno de la cicatriz posquirúrgica de una tenotomía para el tratamiento de una fasciosis plantar recalcitrante y proponemos como tratamiento, con resultados esperanzadores, la hidrodisección nerviosa ecoguiada con anestésico local

Chronic or recalcitrant plantar fasciitis is a cause of persistent plantar pain. These cases are usually resistant to conventional treatments consisting of exercises, orthoses, shock waves and infiltrations and require a surgical approach. Proximal medial gastrocnemius release is a surgical option that provides satisfactory results, but is not free of complications, which include injuries and nerve entrapment. We report the first published case of symptomatic medial gastrocnemius branch entrapment in the post-surgical scar of a tenotomy for the treatment of recalcitrant plantar fasciitis. We propose ultrasound-guided hydrodissection with local anesthetic as a treatment with promising results

[Selective ultrasound-guided hydrodissection of gastrocnemius nerve branch after post-surgical entrapment: Apropos of a case]. / Hidrodisección ecoguiada selectiva de rama nerviosa gemelar tras atrapamiento posquirúrgico: a propósito de un caso.

Chronic or recalcitrant plantar fasciitis is a cause of persistent plantar pain. These cases are usually resistant to conventional treatments consisting of exercises, orthoses, shock waves and infiltrations and require a surgical approach. Proximal medial gastrocnemius release is a surgical option that provides satisfactory results, but is not free of complications, which include injuries and nerve entrapment. We report the first published case of symptomatic medial gastrocnemius branch entrapment in the post-surgical scar of a tenotomy for the treatment of recalcitrant plantar fasciitis. We propose ultrasound-guided hydrodissection with local anesthetic as a treatment with promising results.