Short-Term Operative Outcome of Tarsal Tunnel Syndrome Due to Benign Space-Occupying Lesions

Abstract

Though significant improvement was found in the average VAS and AOFAS score, subjective satisfaction was less favorable (54%) than expected. We believe surgeons should be more cautious concerning outcomes when expectations of surgery are discussed with patients.

The Effect of Medial and Lateral Calcaneal Osteotomies on the Tarsal Tunnel

“…Often patients demonstrate a positive Tinel sign along the course of the tibial nerve, and become more symptomatic with dorsiflexion and eversion at the ankle. 7 Although multiple causes of tarsal tunnel syndrome have been described, including trauma, 11,13 space occupying lesions, 9,17 infection, 2 systemic diseases, 15,16 external compression, 11,19 and ischemia, 1 few reports make any mention of compressive or traction neuropathy as a direct potential result of corrective osteotomy. This mechanism, however, has on 2 occasions been observed by the senior author as the likeliest reason for transient postoperative neuropathy after otherwise uneventful calcaneal tuber translation.…”

Neurolysis for Failed Tarsal Tunnel Surgery

“…The outcomes of TTR have varied, with failure rates of 4% to 56% reported (1,2,4,7), particularly in patients in whom a specific etiology could not be identified (10). We believe that these rates do not always reflect the "true" failure rate, because many studies have been of varieties of surgical release, including extensile release (11), the 4-medial ankle tunnel release (tibialis posterior, medial and lateral plantar nerves, and calcaneal nerve) (1,3,7,12,13), proximal-only TTR (2,3), distal-only TTR (6,14), selective nerve release (2,4,6,15), and shorter incisions (16). Again, only a few studies have been published and have included small numbers of patients with failed TTR, variable results, and a wide range of surgical procedures (4).…”

“…Many causes of TTS are known, including trauma, foot deformities, and space-occupying lesions (i.e., ganglia, lipomas, accessory muscles, varicosities, and tenosynovitis), but still, many cases will be idiopathic (3). The choice of treatment is operative decompression when conservative methods have failed to improve the symptoms.…”

Acute Posterior Tarsal Tunnel Syndrome Caused by Gouty Tophus

“…12 However, subjective satisfaction was less favorable than expected. 13 This was due to the background neuropathy.…”