Results of ultrasound-guided release of tarsal tunnel syndrome: a review of 81 cases with a minimum follow-up of 18 months

Abstract

Background: This study aims to analyse the clinical results of ultrasound-guided surgery for the decompression of the tibial nerve, including its distal medial and lateral branches, to treat tarsal tunnel syndrome. These structures are the complete flexor retinaculum and the deep fascia of the abductor hallucis muscle, including individualised release of the medial and lateral plantar nerve tunnels. Method: This is a retrospective review of 81 patients (36 men and 45 women) with an average age of 41 years old (32-62) and an average clinical course of 31 months (8-96) compatible with idiopathic tarsal tunnel syndrome, who underwent ultrasound-guided decompression of the proximal and distal tarsal tunnel between February 2015 and November 2017 (both months included), with a minimum follow-up of 18 months. Results: Based on the Takakura et al. scale for the 81 patients, 76.54% obtained excellent results, 13.58% good results, and 9.87% poor results. The patients with the longest course of symptoms displayed the worst results. Conclusion: Although 9% of patients did not improve, ultrasound-guided tarsal tunnel release might be a viable alternative to conventional open approaches.

Ultrasound-guided topographic anatomy of the medial calcaneal branches of the tibial nerve

“…Iborra et al [18,19] and Mullick et al [29] confirm that the use of ultrasound in the tarsal tunnel syndrome operative treatment leads to respectively 90.12% and 93% excellent and good results. In the cadaveric study the authors proved that a high-resolution ultrasonography can visualize the entire course of the tibial nerve as well as its tiny branches which may be applied in the decompression surgeries [18,19,29]. Also a sonosurgery, which is a "minimally invasive surgical technique performed with the continuous ultrasound imagining and the use of endoscopic tools" seems promising in improving the surgical result by reducing the risk of iatrogenic injuries [34].…”

A novel closed technique for ultrasound-guided plantar fascia release with a needle: review of 107 cases with a minimum follow-up of 24 months

“…Ultrasound-guided surgery is a novel approach with proven indications, such as gastrocnemius lengthening, carpal tunnel release, tarsal tunnel release, and plantar fasciitis [ 12 , 32 – 34 ]. Our technique is based on the concept of McShane et al, who described ultrasound-guided release of the carpal tunnel with an Abbocath [ 35 ], and can be considered a progression of the techniques previously described by the authors in 2014 with a scalpel and in 2016 with a needle.…”

Considerations in the Diagnosis and Treatment of Morton’s Entrapment: A Review

“…As the tibial nerve courses distally past the knee joint, its motor fibers to the posterior compartment of the leg and enters the tarsal tunnel at the level of the medial malleolus [7]. The tibial nerve then typically bifurcates just distal to the laciniate ligament at the tarsal tunnel to form both the medial and lateral plantar nerves [8]. Those two nerves work in tandem to provide sensation to the plantar aspect of the foot form their proper digital branches distally.…”