Surgical repair of the medial head of the gastrocnemius: two case reports and review.

The gastrocnemius medial head distal musculotendinous junction injury is relatively common. Musculature contraction in an already stretched structure leads to muscle breakdown. Patients affected are often physically active middle-aged men. The typical presentation includes sudden pain, audible popping, bruising and localized tenderness. Occasionally, there is a palpable defect if the rupture is complete. Although the initial diagnosis can be made on the basis of a careful history and clinical examination, ultrasound or magnetic resonance imaging can be used to better describe the lesion. In complete ruptures, even when conservative treatment shows good results, it is common that the patient presents decreased muscle strength, difficulty returning to sports and permanent and visible gap. Considering surgical treatment in patients with complete ruptures and extensive injuries with a more than 5 cm gap may lead to better healing process, rapid rehabilitation and more efficient return to sports.