A case of osteophyte excision and arthroscopic arthrodesis for tarsal tunnel syndrome with traumatic osteoarthritis of the ankle.

Introduction: There are some reports of tarsal tunnel syndrome (TTS) entrapment/impingement from bony factors, including exostosis and fragment, but there are no reports on TTS with traumatic osteoarthritis of the ankle that were treated with osteophyte excision for TTS and arthroscopic arthrodesis for osteoarthritis of the ankle.

Presentation Of Case: A 61-year-old woman with left trimalleolar fracture had undergone surgery 3 years earlier and was referred to our hospital for further investigation of persistent left ankle pain and numbness around the left medial malleolus and plantar aspect of the foot. Clinical examination demonstrated plantar hypesthesia and a positive Tinel's sign at the tarsal tunnel. Imaging showed severe osteoarthritic change in the ankle and an osteophyte of the posteromedial distal tibia that appeared to be impinging on the tibial nerve. We performed arthroscopic ankle arthrodesis, which is less invasive than the open procedure, with removal of the osteophyte as the cause of TTS. Tarsal tunnel exploration revealed a large osteophyte pushing on the tibial nerve, and the osteophyte was removed.

Discussion: About 8 weeks after surgery, bony union was achieved. At the 2-year follow-up visit, the patient could perform daily activities with almost no pain or numbness. This case offers further insight into the management of TTS with traumatic osteoarthritis of the ankle.

Conclusion: We report here successful treatment of a rare case of tarsal tunnel syndrome (TTS) accompanied with traumatic osteoarthritis of the ankle, treated with osteophyte excision for the TTS and arthroscopic for the osteoarthritis.