Which technique is described as a gastrosoleus lengthening option besides Z-lengthening?

• A. Tarsal tunnel release
• B. Gastrocnemius release
• C. Double/triple hemisection TAL
• D. Z-lengthening TAL

Answer: (C)

When addressing ankle equinus from a tight gastrosoleus complex, there are several ways to lengthen the posterior tendon unit. Besides a Z-lengthening, a recognized option is performing partial cuts in the Achilles tendon through a hemisection approach. By doing double or triple hemisections, you lengthen the tendo-Achilles in a controlled, gradual fashion while keeping most of the tendon intact. This method preserves structure and strength better than a full-lengthening cut and allows targeted increases in ankle dorsiflexion. Tarsal tunnel release is a nerve decompression procedure and does not lengthen the gastrosoleus; a gastrocnemius release targets the muscle belly rather than the Achilles tendon; the Z-lengthening itself is the classic tendon-lengthening method, with the double/triple hemisection TAL providing an alternative technique.