Lower Leg Muscle Repair

Lower Leg Muscle Repair

What is Lower Leg Muscle Repair?

Lower leg muscle repair is a surgical procedure to treat lower leg muscle strains.

Lower leg muscle strains are defined as a tear or rupture of either the gastrocnemius or soleus muscle, typically at the point they attach to the Achilles tendon. Lower leg muscle strains occur when segments of the lower leg muscles are stretched beyond their capacity to withstand the tension. This stretching can lead to small microtears of the muscle fibers, or in an acute injury, a total rupture of the muscle fibers. These injuries typically occur due to a sudden pushing-off force, or an overstretch of the calf muscles. Lower leg muscle strains are commonly known as calf muscle strains. They normally heal with conservative treatments, but occasionally require surgery.

Anatomy of Lower Leg Muscles

The lower leg muscles or calf muscles (gastrocnemius and soleus muscle) are located in your lower leg behind the tibia (shin bone) and extend from the base of your thigh down to your heel. They meet at the Achilles tendon, which is attached to the heel bone. Lower leg muscles assist you in bending and flexing your knee, ankle, and foot. During running, jumping, or walking, the lower leg muscle pulls the heel up to allow forward movement.

Indications for Lower Leg Muscle Repair

Lower leg muscle repair is commonly indicated for a torn or pulled lower leg or calf muscle. A pulled calf muscle, or a calf muscle strain, occurs when the soleus and gastrocnemius get overstretched. These muscles can even tear with sudden movements that severely overstretch them. Your doctor may recommend surgical repair for your lower leg muscle or calf muscle tear if you:

• Have a complete muscle tear with severe swelling or internal bleeding.
• Continue to experience calf pain several months after trying conservative treatments such as rest, ice, compression, and elevation.
• Are young and wish to return to high-impact activities or competitive sports.

Preparation for Lower Leg Muscle Repair

Preparation for lower leg muscle repair may involve the following steps:

• A review of your medical history and a physical examination to check for any medical issues that need to be addressed prior to surgery.
• Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could compromise the safety of the procedure.
• You will be asked if you have allergies to medications, anesthesia, or latex.
• You should inform your doctor of any medications or supplements you are taking, and any conditions you have such as heart or lung disease.
• You may be asked to stop taking blood thinners, anti-inflammatories, aspirin, or other supplements for a week or two.
• You should refrain from alcohol and tobacco at least a few days prior to surgery and several weeks after, as they can hinder the healing process.
• You should not consume solids or liquids at least 8 hours prior to surgery.
• You should arrange for someone to drive you home after surgery.
• A signed informed consent form will be obtained from you after the pros and cons of the surgery have been explained.

Procedure for Lower Leg Muscle Repair

In general, the procedure for lower leg muscle repair involves the following:

• You will be administered local or general anesthesia prior to beginning the surgery and placed in a face-down position on the procedure table.
• After thoroughly cleaning the treatment area with an antiseptic solution, your surgeon will make an incision in your calf.
• Retractors are used to expose the treatment area, and the two ends of the torn muscle are reattached with stitches.
• After confirming satisfactory muscle repair, your surgeon will remove the retractors and close the incision with sutures or steri-strips and a sterile dressing.
• The repaired leg will then be placed in a cast for about 3 weeks to promote healing and protect the treated area.

Postoperative Care and Recovery

In general, postoperative care and recovery after lower leg muscle repair involve the following steps:

• You will be transferred to the recovery area where your nurse will closely observe you for any allergic/anesthetic reactions and monitor your vital signs.
• You may experience pain, swelling, and discomfort around the operated area. Pain and anti-inflammatory medications are provided to address these.
• Antibiotics are also prescribed to address the risk of surgery-related infection.
• You are encouraged to move around in bed and walk as frequently as possible to prevent the risk of blood clots.
• You are advised not to bear weight on your operated foot for a defined period and will be prescribed crutches or a walker to help with mobility.
• Instructions on incision site care and bathing will be provided to keep the wound clean and dry.
• An individualized physical therapy program will be designed to help strengthen your lower leg muscles and regain normal leg movement.
• You should be able to resume your normal activities in a few months, but a return to sports and high-impact activities may take 6 months or longer.
• Refrain from driving until you are fully fit and receive your doctor’s consent.
• A periodic follow-up appointment will be scheduled to monitor your progress.

Risks and Complications

Lower leg muscle repair is a relatively safe procedure; however, as with any surgery, some risks and complications may occur, such as the following:

• Infection
• Bleeding
• Postoperative pain
• Thromboembolism or blood clots
• Adverse reactions to anesthesia
• Damage to surrounding soft tissue structures, such as nerves and vessels