Background: There is only limited objective
information about functional donor-site morbidity after harvest
of one head of the triceps surae muscles to cover a severe soft-tissue
defect of the leg. The purpose of the present study was to investigate
whether a functional deficit is present during level and uphill walking
after such a procedure.
Methods: Five subjects who had completely recovered
from the initial injury were studied with use of comprehensive gait
analysis during free level, fast level, and uphill walking on a
ramp at a 10° inclination.
Results: Gait analysis revealed no relevant donor-site
morbidity affecting level gait at a free walking speed (mean, 1.27
m/sec; range, 1.18 to 1.40 m/sec). When the subjects walked at a
higher velocity (mean, 1.89 m/sec; range, 1.58 to 2.43 m/sec), an asymmetry
of the ground-reaction forces was seen. The second vertical peak
force during push-off was reduced by a mean of 7.3% (range, 0.94%
to 12.24%), and the impulse in the direction of progression was
reduced by a mean of 8.7% (range, 0.13% to 17.87%) on the affected
side (p = 0.04). During uphill walking, a compensatory strategy
to reduce the demand on the posterior calf muscles was seen in all
subjects-that is, they shortened the length of the step on the contralateral
side by a mean of 3.9 cm (range, 2.2 to 6.2 cm), which corresponded
to a mean side-to-side difference of 5.6% (range, 2.18% to 6.18%)
(p = 0.04). A calcaneal motion pattern, denoted as increased ankle
dorsiflexion, was seen in three of the five subjects during uphill
walking as a sign of decreased function of the posterior calf muscles.
Two of them (both with a soleus flap) also had a calcaneal pattern
during fast gait.
Conclusions: We concluded from this study that the
functional donor-site morbidity after harvest of one head of the
triceps surae muscles is mild in subjects who have had a complete
recovery from their initial injury. Normal level gait is possible.
However, deficits are seen in more demanding tasks such as fast walking
or uphill walking.