Patterns of posterior calf injury due to sports related activities and their USG correlation

Abstract

Abstract Introduction– Posterior calf injury are a far less common presentation than the more commonly seen Achilles tendon injury in the orthopaedic department. Hence these need to be identified correctly for proper diagnosis and treatment of this clinical entity. Background– Three posterior calf muscle, namely plantaris, Soleus and Gastrocnemius together constitute the ‘Triceps Surae’. Its strain is usually seen associated with sports related activities. Aims and objectives – To identify the various patterns of posterior calf injury and their USG correlation. Material and methods – During a period of 6 months, (April 2021 to September 2021), a total of 15 patients, who presented to orthopaedic department with complaints of sports related injury to the posterior calf were included in the study after obtaining proper informed consent. After proper history taking and examination, Realtime USG scans were done using high frequency (8 to 12 MHz) probe and findings noted. Results– In our study, 15 patients with sports related posterior calf injury and their USG findings were evaluated. The mean age of the study group was 37.53. Left side (60%) was involved more than the right side (40%). Of the 15 patients, 12 (80%) were male and 3 (20%) were female. The most common activity associated with the injury was cricket (66.7%), followed by football (20%) and lastly running (13.3%). The USG scans showed Isolated Gastrocnemius strain to be the most frequent finding (60%), 44% of which were associated with fluid collection and 3 (33%) with thrombosis of Gastrocnemius vein. One patient with Soleus strain, one with strain of both Soleus and Tibialis posterior and one with combined Gastroc-Soleus strain were other muscular injuries noted. 3 patients had no triceps surae rupture but only fluid collection in the muscular planes (2) or thrombosis of Gastrocnemius vein (1). Conclusion– Our study has identified that posterior calf injury is commonly seen in middle aged patients, involved with any sports activities. The strain of gastrocnemius muscle is the most common presentation (60%), more commonly on the left side (60%) and is usually associated with cricket (66.7%). These should be kept in mind while attending a patient with similar presentation.