In tarsal tunnel syndrome, vascular compression beneath the flexor retinaculum has been suggested as one of the causes of nerve insult. We have attempted reconstruction of the tunnel after transposition of the vasculature from the tunnel. However, among 205 lesions with tarsal tunnel syndrome surgically treated using such a reconstruction method, we experienced 6 recurrences. Adhesion and compression by granulation in the reconstructed tarsal tunnel was a common finding. To avoid this, we designed a new method. After the flexor retinaculum is incised slightly to the medial side of the tunnel, the posterior tibial artery and the medial and lateral plantar veins vascular complex are detached from the medial and lateral plantar nerve. The vascular complex is then relocated from the tunnel and wrapped with the flexor retinaculum laterally outside the tunnel. This method may be more effective than preexisting ones. Long term efficacy of our method is to be proved in accumulation of experiences.
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