Tarsal tunnel syndrome describes the compression of the tibial nerve through the tarsal tunnel which results in pain and numbness in the plantar aspect of the foot. The tibial nerve has three major branches which include the calcaneal, medial plantar, and lateral plantar nerve branches. There are two primary structures responsible for compression of the tibial nerve: (1) flexor retinaculum and (2) a septum that compartmentalizes the medial and lateral plantar nerves and the overlying fascia of the abductor hallucis muscle. The tarsal tunnel release involves releasing these structures. In this case, the patient had a traumatic injury to the lower leg, which required open reduction and internal fixation. The patient had pain and numbness in the tibial nerve distribution along with Tinel’s sign and positive scratch collapse at the tarsal tunnel.
Standard:
Extended:
POSITION
Supine.
INCISION
Two incision are involved for a tarsal tunnel release. (1) The first incision is on the posterior third of the medial aspect of the lower leg along the course of the tibial nerve. (2) The second incision is at an angle along the course of the lateral plantar branch of the tibial nerve.
REFERENCES
- Gondring WH, Shields B, Wenger S. An outcomes analysis of surgical treatment of tarsal tunnel syndrome. Foot Ankle Int. 2003 Jul;24(7):545-50. PMID: 12921360.
- Sammarco GJ, Chang L. Outcome of surgical treatment of tarsal tunnel syndrome. Foot Ankle Int. 2003 Feb;24(2):125-31. PMID: 12627619.
- Bailie DS, Kelikian AS. Tarsal tunnel syndrome: diagnosis, surgical technique, and functional outcome. Foot Ankle Int. 1998 Feb;19(2):65-72. Review. PMID: 9498577.
- Dellon AL, Mackinnon SE. Tibial nerve branching in the tarsal tunnel. Arch Neurol. 1984 Jun;41(6):645-6. PMID: 6721738.
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.