Surgical Treatment of a Tarsal Tunnel Syndrome

Czech version

Authors: R. Kaiser; P. Haninec
Authors‘ workplace: Neurochirurgická klinika 3. LF UK a FN Královské Vinohrady, Praha
Published in: Cesk Slov Neurol N 2012; 75/108(3): 351-353
Category: Short Communication

Overview

Entrapment neuropathies of the lower limbs are rare. We present a series of four patients treated for tibial nerve compression in the tarsal tunnel. The symptoms developed spontaneously in two patients while the other two had a history of ankle injury. Transection of the flexor retinaculum and exoneurolysis of the tibial nerve and its branches was effective in all patients. The tarsal tunnel syndrome should be considered in all patients who develop pain and sensory disturbances in the sole and have a negative finding in the lumbar spine. EMG confirms the finding. Surgical treatment is simple and has good results.

Key words:
entrapment syndrome – tibial nerve – tarsal tunnel syndrome

Sources

1. Lam SJ. A tarsal-tunnel syndrome. Lancet 1962; 2(7270): 1354–1355.

2. Rodriguez D, Devos Bevernage B, Maldague P, Deleu P, Leemrijse T. Tarsal tunnel syndrome and flexor hallucis longus tendon hypertrophy. Orthop Traumatol Surg Res 2010; 96(7): 829–831.

3. Cancilleri F, Ippolito M, Amato C, Denaro V. Tarsal tunnel syndrome: Four uncommon cases. Foot Ankle Surg 2007; 13(4): 214–217.

4. Lukáš E. The tarsal tunnel syndrome. Cesk Slov Neurol N 1987; 50/83(6): 395–398.

5. Sammarco GJ, Conti SF. Tarsal tunnel syndrome caused by an anomalous muscle. J Bone Joint Surg (Am) 1994; 76: 1308–1314.

6. Kinoshita M, Okuda R, Yasuda T, Abe M. Tarsal tunnel syndrome in athletes. Am J Sports Med 2006; 34(8): 1307–1312.

7. Mezrow CK, Sanger JR, Matloub HS. Acute tarsal tunnel syndrome following partial avulsion of the flexor hallucis longus muscle: a case report. J Foot Ankle Surg 2002; 41(4): 243–246.

8. Miranpuri S, Snook E, Vang D, Yong RM, Chagares WE. Neurilemoma of the posterior tibial nerve and tarsal tunnel syndrome. J Am Podiatric Med Assoc 2007; 97(2): 148–150.

9. Ehler E, Latta J. Compression neuropathies as an occupational disease. Prakticky Lekar 2008; 88(9): 515–520.

10. Kim DH, Cho Y, Ryu S, Tiel RL, Kline DG, Huang JH et al. Surgical management and results of 135 tibial nerve lesions at the Louisiana state university health sciences center. Neurosurgery 2003; 53(5): 1114–1125.

11. Galardi G, Amadio S, Maderna L, Meraviglia MV, Brunati L, Dal Conte G et al. Electrophysiologic studies in tarsal tunnel syndrome: Diagnostic reliability of motor distal latency, mixed nerve and sensory nerve conduction studies. Am J Phys Med Rehabil 1994; 73(3): 193–198.

12. Erickson SJ, Quinn SF, Kneeland JB, Smith JW, Johnson JE, Carrera GF et al. MR imaging of the tarsal tunnel and related spaces: Normal and abnormal findings with anatomic correlation. Am J Roentgenol 1990; 155(2): 323–328.

13. Day FN jr, Naples JJ. Tarsal tunnel syndrome: an endoscopic approach with 4-to 28-month follow-up. J Foot Ankle Surg 1994; 33(3): 244–248.