Background: Tarsal tunnel syndrome (TTS) is an entrapment neuropathy in which the tibial nerve is compressed within the tarsal tunnel and causes sensory disturbance in the sole of the foot. In this manuscript, we summarized our early surgical cases of TTS.
Materials And Methods: Six feet in five patients with TTS were treated surgically. The patients were aged 31-70 years (mean 53.1 years), and all of them complained of pain or dysesthesia of the sole of the foot sparing the heel. Magnetic resonance imaging (MRI) and nerve conduction test were performed preoperatively. In surgery, flexor retinaculum was dissected (tarsal tunnel opening [TTO]), the posterior tibial nerve was freed from the arteriovenous complex (neurovascular decompression [NVD]), and fascia of the abductor hallucis muscle was excised to decompress the medial and lateral plantar nerve (releasing fascial of abductor hallucis muscle [RFAH]).
Results: Preoperative MRI confirmed that all seven cases were idiopathic TTS. Moreover, NCD demonstrated delayed sensory conduction velocity but not delayed distal motor latency. Surgical decompression was beneficial in 5 feet. The recurrence of symptoms was found in one case within 1 postoperative month.
Conclusion: Surgical treatment for idiopathic TTS with TTO, NVD, and RFAH was generally good. However, symptoms recurred in one instance. Some methods to prevent adhesion and granulation in the reconstructed tarsal tunnel should be considered.
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http://dx.doi.org/10.4103/ajns.AJNS_257_19 | DOI Listing |
J Am Podiatr Med Assoc
January 2025
‖Pain Therapy Associates, Schaumburg, IL.
Background: Although an association between peripheral nerve entrapment issues and rheumatoid arthritis (RA) has been found, research has generally focused solely on nerve entrapment in the upper or lower extremity individually rather than on the consideration of nerve entrapment simultaneously in the upper and lower extremities. In addition, most of these studies have used small sample sizes. The aim of this study was to evaluate the incidence of carpal tunnel syndrome (CTS) and tarsal tunnel syndrome (TTS) concurrently in patients with RA using a relatively large sample size.
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January 2025
Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar.
Entrapment neuropathies of the lower extremity are often underdiagnosed due to limitations in clinical examination and electrophysiological testing. Advanced imaging techniques, particularly MR neurography and high-resolution ultrasonography (US), have significantly improved the evaluation and diagnosis of these conditions by enabling precise visualization of nerves and their surrounding anatomical structures. This review focuses on the imaging features of compressive neuropathies affecting the lumbosacral plexus and its branches, including the femoral, obturator, sciatic, common peroneal, and tibial nerves.
View Article and Find Full Text PDFJ Am Podiatr Med Assoc
January 2025
*Western University of Health Sciences, College of Podiatric Medicine, Pomona, CA.
Variations of the ankle anatomy are infrequent and exist as supernumerary muscles and tendons. Often understudied and overlooked, their presence can cause many complications of the lower extremity. These muscles, although often asymptomatic, can cause great pain and complications such as tenosynovitis, tarsal tunnel syndrome, lateral ankle instability, and ankle pain when they impinge on the normal anatomy of the patient.
View Article and Find Full Text PDFQuant Imaging Med Surg
January 2025
Division of Plastic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Background And Objective: Diabetic neuropathy significantly elevates the risk of foot ulceration and lower-limb amputation, underscoring the need for precise assessment of tissue perfusion to optimize management. This narrative review explores the intricate relationship between sympathetic nerves and tissue perfusion in diabetic neuropathy, highlighting the important role of autonomic neuropathy in blood flow dynamics and subsequent compromises in tissue perfusion. The consequences extend to the development of diabetic peripheral neuropathy and related foot complications.
View Article and Find Full Text PDFIowa Orthop J
January 2025
Department of Orthopedics, Lifeline Multispecialty Hospital, Adoor, India.
Tarsal tunnel syndrome (TTS) refers to compression of the posterior tibial nerve as it traverses the tarsal tunnel in the ankle. First described by Keck and Lam in 1962, TTS is an underdiagnosed cause of heel pain and foot dysfunction. The tarsal tunnel contains the tibial nerve, posterior tibial artery, and tendons of the tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles.
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