Shawn C. Ward, DPM, FACFAS
Foot and Ankle Surgery, Mercy Health - St. Rita's Medical Center, Lima, OH
Background
Tarsal tunnel syndrome (TTS) is a compressive neuropathy of the posterior tibial nerve and its distal branches within the tarsal tunnel beneath the flexor retinaculum, first described by Keck and Lam in the 1960s.1,2 Although less prevalent than other lower extremity entrapment neuropathies, TTS represents a clinically significant and often debilitating cause of chronic foot and ankle pain. Symptoms are variable and frequently misdiagnosed as musculoskeletal heel pain. Patients commonly report progressive aching or burning pain involving the ankle, heel, and plantar foot, often accompanied by paresthesias or radiating plantar symptoms. Examination may reproduce symptoms with deep palpation and is often notable for a positive Tinel’s sign.3 TTS may be associated with systemic conditions such as diabetes and inflammatory arthropathies, as well as local factors including space-occupying lesions, post-traumatic scarring, and biomechanical abnormalities. A substantial proportion of cases remain idiopathic.3
1
Click the link above to download the full technique guide.
CS-9095-MKT-030-A
References
- Keck C. The Tarsal-Tunnel Syndrome. J Bone Joint Surg [Am]. 1962;44-A:180–182.
- Lam SJ. Tarsal tunnel syndrome. J Bone Joint Surg Br. 1967;49(1):87-92.
- Fortier LM, Leethy KN, Smith M, et al. An Update on Posterior Tarsal Tunnel Syndrome. Orthop Rev (Pavia). 2022;14(4):35444.
- Mook WR, Gay T, Parekh SG. Extensile decompression of the proximal and distal tarsal tunnel combined with partial plantar fascia release in the treatment of chronic plantar heel pain. Foot Ankle Spec. 2013;6(1):27-35.
- Liu WC, Raasveld FV, Mayrhofer-Schmid M, Eberlin KR, Valerio IL. Three Useful Tips and Tricks for Intraoperative Nerve Stimulation. Plast Reconstr Surg Glob Open. 2024;12(3):e5640
Please note: Case reports and white papers are company funded and not peer reviewed.
