El acortamiento del gemelo, o retracción del músculo gastrocnemio, es una alteración muy común que a menudo pasa desapercibida. Esta limitación provoca una restricción en la flexión dorsal del tobillo, obligando al pie a compensar y generando sobrecarga en la fascia plantar, el tendón de Aquiles y los metatarsianos.
Con el tiempo, esta tensión excesiva puede derivar en fascitis plantar crónica, metatarsalgia o dolor en el antepié.
Cuando los ejercicios de estiramiento y la fisioterapia no consiguen mejorar la movilidad, la cirugía ecoguiada de alargamiento de gemelo se convierte en una alternativa eficaz y segura.
¿Qué es el alargamiento de gemelo ecoguiado?
La cirugía ecoguiada del gemelo es una técnica mínimamente invasiva que permite liberar de forma controlada las fibras del músculo gastrocnemio mediante una punción de apenas unos milímetros.
El procedimiento se realiza con anestesia local y bajo control ecográfico en tiempo real, lo que permite al Dr. Rubén Montes Salas actuar con total precisión y seguridad.
Durante la intervención, el Dr. Rubén Montes Salas utiliza una aguja o bisturí específico para realizar una liberación selectiva del gemelo medial o lateral, según el caso. Todo el proceso dura menos de 15 minutos y no requiere puntos de sutura.
Ventajas de la cirugía ecoguiada frente a la técnica abierta
A diferencia de la cirugía tradicional, el alargamiento de gemelo ecoguiado no necesita incisiones amplias ni hospitalización.
Entre sus principales ventajas destacan:
- Mínima agresión quirúrgica, ya que solo requiere una punción.
- Recuperación rápida y con menor dolor postoperatorio.
- Menor riesgo de complicaciones gracias al control ecográfico.
- Ausencia de cicatrices visibles y sin necesidad de puntos.
La mayoría de los pacientes retoman su actividad habitual en una o dos semanas, lo que hace de esta técnica una opción ideal para deportistas y personas activas.
Indicaciones del alargamiento de gemelo
Esta intervención está indicada cuando existe un acortamiento aislado del gemelo (test de Silfverskiöld positivo) asociado a:
- Fascitis plantar resistente al tratamiento conservador.
- Metatarsalgia o dolor bajo los metatarsianos.
- Tendinopatía aquílea o sobrecarga del tendón de Aquiles.
- Limitación de la dorsiflexión del tobillo que afecta la marcha o el rendimiento deportivo.
En estos casos, la liberación controlada del gastrocnemio mejora la movilidad y reduce la tensión sobre las estructuras del pie.
Recuperación tras el alargamiento ecoguiado del gemelo
Tras la cirugía, el paciente camina desde el primer día con ayuda de una bota Walker, que se mantiene durante los primeros días para proteger la zona y facilitar una correcta cicatrización.
Posteriormente, se sustituye por calzado cómodo y se inician ejercicios suaves de movilidad.
En la mayoría de los casos, el dolor y la rigidez mejoran de forma significativa durante las primeras semanas.
A medio plazo, se consigue una mejor distribución de las cargas en el pie y una disminución notable de la sobrecarga plantar y tendinosa.
Una técnica moderna y precisa
La cirugía ecoguiada de alargamiento de gemelo representa un gran avance dentro de la cirugía podológica mínimamente invasiva.
Permite tratar de forma definitiva una causa frecuente de sobrecarga del pie con un procedimiento rápido, preciso y prácticamente indoloro.
En manos del Dr. Rubén Montes Salas, especialista en cirugía ecoguiada de ultra mínima incisión, esta técnica ofrece excelentes resultados funcionales y estéticos, mejorando la calidad de vida de pacientes que antes convivían con dolor o rigidez crónica.
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