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Tarsal tunnel syndrome is an infrequent and probably underdiagnosed clinical condition. Diagnosis and treatment depend on understanding the tibial branching pattern within the tarsal tunnel. A total of 68 foot dissections were performed. Bifurcation into the medial and lateral plantar nerves occurred within the tunnel in 93% and proximal in 7%. Proximal bifurcation may predispose to tarsal tunnel syndrome, and its infrequent occurrence correlates with the infrequent clinical diagnosis. Nine different calcaneal branching patterns were noted; they provide an anatomical explanation for heel sparing. An understanding of anatomic variations should aid in providing complete surgical release and in avoiding accidental heel denervations.

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Fractures of the body of the hamate are unusual. Eleven patients with coronal fractures of the hamate bone, all involving dislocation of the hamate-metacarpal joint, are reported. Routine roentgenograms were not helpful in delineating the presence of the injury in five patients; therefore, fracture diagnosis was not initially made in those patients. The average delay in diagnosis of this group was 10 days. A 30-degree pronated view, tomograms, and computed tomography scans may be necessary in the diagnosis of this injury. This fracture was found to be highly unstable. Ten patients underwent surgery for stabilization of their fractures and restoration of the congruity of the hamate-metacarpal joint. Four patients were treated with open reduction and internal fixation of the fracture. Six patients were treated with closed reduction and percutaneous pinning. All patients treated surgically had maintenance of reduction of their joints. One patient was treated with closed reduction and casting; reduction in this case was lost, and the patient developed residual subluxation of the hamate-metacarpal joint.

A total of 16 wrists from three men and five women, 25-32 years old, were evaluated. All subjects but two were chosen at random from a healthy and asymptomatic volunteer pool of AJR

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