Tarsal tunnel syndrome is an entrapment neuropathy of the tibial nerve and its branches in the tarsal tunnel. The literature on surgical release of the tarsal tunnel shows variable outcomes with no studies reporting validated patient reported outcomes. We aim to determine clinical response after tarsal tunnel release using the Patient-Reported Outcomes Measurement Information System (PROMIS). CPT code 28035 was used to identify patients who underwent isolated tarsal tunnel release (TTR) between 1/1/2015 and 12/15/2022 at a single institution. Patient demographic data and PROMIS physical function (PF), pain interference (PI), and depression scores were prospectively collected at the initial pre-operative clinic visit and in follow-up throughout the episode of care after TTR. The validated distribution-based method (1/2 sd) was used to assess minimal clinically important difference (MCID) and bivariate analysis was used to determine postoperative recovery. A total of 39 patients who underwent TTR were included. The mean t-score change (pre- to post-operation) was 7.2 for PF, -6.1 for PI, and -5.93 for depression. MCID thresholds were calculated as PF increase of 4.7, PI decrease of 3.9, and depression decrease of 5.1. Fourteen (35 %), 24(62 %), and 27 (69 %) patients reached MCID for PF, PI, and depression, respectively. No relationship was observed between space-occupying lesions and patient outcomes. This study provides validated outcomes after TTR. Though there is significant improvement after surgery, the patients still experience some pain and physical limitations.
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http://dx.doi.org/10.1053/j.jfas.2025.01.005 | DOI Listing |
J 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.
View Article and Find Full Text PDFJ Foot Ankle Surg
January 2025
University of Rochester Department of Orthopaedic Surgery, 601 Elmwood Ave, Rochester, NY 14642.
Tarsal tunnel syndrome is an entrapment neuropathy of the tibial nerve and its branches in the tarsal tunnel. The literature on surgical release of the tarsal tunnel shows variable outcomes with no studies reporting validated patient reported outcomes. We aim to determine clinical response after tarsal tunnel release using the Patient-Reported Outcomes Measurement Information System (PROMIS).
View Article and Find Full Text PDFCureus
December 2024
Trauma and Orthopedics, Lister Hospital, Stevenage, United Kingdom.
Necrotizing fasciitis is a severe and rapidly progressing soft tissue infection that requires immediate intervention. However, its manifestation as tarsal tunnel syndrome in a diabetic patient is an extremely rare occurrence, with no previous reports found in the existing literature. We present a case report of a patient in their late 50s with uncontrolled diabetes who had necrotizing fasciitis and presented initially to the emergency department with hypotension.
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