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Asia Pacific Society for Foot and Ankle Surgery 3rd Scientific Meeting

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Venue: Prince of Wales Hospital
Date: 17-18th October 2015

Apes, Evolution, and the Root of All Evil in Disorder of the Foot by Dr. Chong Keen Wai

As humans evolved from quadrupedal gait to a bipedal gait pattern, our Achilles tendon, in particular the gastrocnemius component of the Achilles tendon was required to undergo lengthening to allow a plantigrade stance. However, in reality, many of us still preserves some degree of gastrocnemius equinus contracture. The vast majority has mild or no symptoms and should rightfully be left alone. However, many disorders of the foot can be traced to the problem of gastrocnemius tightness and the ensuing biomechanical abnormalities. Problems such as flat feet, bunions, claw toes, diabetic Charcot arthropathy, stress fractures, midfoot osteoarthritis, metatarsalgia, planta fasciitis, Achilles tendinopathy are in one way or the other, caused by such a biomechanical problem. Increasingly, clinical outcomes and research has shown that solving this by physical therapy or by surgery, does lead to good clinical outcomes and minimal adverse effects. Surgical techniques has also changed. Minimally invasive gastrocnemius recession has improved recovery times and cosmesis.

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