Soft tissue chondroma compression—A unique cause of tarsal tunnel syndrome: A case report and review of the literature (original) (raw)
Related papers
Tarsal tunnel syndrome: Four uncommon cases
Foot and Ankle Surgery, 2007
Tarsal tunnel syndrome is rarely diagnosed. We describe four uncommon cases treated in our department: a case of angioleiomyoma of the tarsal tunnel never reported in the literature, a case of neurilemoma of the posterior tibial nerve, a big ganglion of the tibiotarsal joint and a pes planus with valgus talus in a young male affected by cerebral palsy. All the cases were treated by surgery with a good outcome. The article includes a discussion about aetiology, diagnosis and treatment of this syndrome.
The tarsal tunnel syndrome after a proximal lesion
Journal of Neurology Neurosurgery and Psychiatry, 1992
Three patients in whom the first symptoms ofthe tarsal tunnel syndrome (TTS) emerged after an acute event proximal to but not affecting the ankle are described. These patients suggest that a pre-existing asymptomatic TTS may become manifest after a mechanism akin to that described in the "double crush" syndrome.
The surgical treatment of tarsal tunnel syndrome
The Foot, 2005
Tarsal tunnel syndrome is an entrapment neuropathy involving the posterior tibial nerve within the tarsal canal. Typical symptoms include burning pain and paraesthesia along the medial ankle and plantar aspect of the foot. Although potential causes of tarsal tunnel syndrome include trauma, varicosities, tenosynovitis, space-occupying lesions, and hindfoot deformity, in most cases the aetiology is idiopathic. Surgical release of the posterior tibial nerve and its terminal branches is indicated if symptoms persist despite non-operative treatment. In this article, we discuss the pre-operative evaluation of these patients and illustrate in detail our preferred technique for surgical release.
Orthopaedics & Traumatology: Surgery & Research, 2020
Introduction: The axial cross-sectional area (CSA) of the tibial nerve can be measured with ultrasonography. In patients who have posteromedial tarsal tunnel syndrome (TTS), there is little information on the nerve's CSA even though this information could be useful for determining whether the nerve is damaged. This led us to carry out a case-control study in which the tibial nerve's axial CSA was measured in healthy patients and in patients with TTS. Hypothesis: The tibial nerve's axial CSA can be used as a diagnostic criterion for TTS. Methods: Twenty-three patients (27 feet) (11 men, 12 women, mean age = 54 ± 14 years), who had clinical and electroneuromyography signs of TTS, were compared to 21 healthy adults (8 men, 13 women, mean age 39 ± 10 years). An ultrasonography examination was carried out to look for a source of nerve compression, then the axial CSA of the tibial nerve was measured 10 cm above the tarsal tunnel (l CSA) and inside the tunnel itself (tt CSA). The difference between the two measurements was then calculated: CSA = tt CSAl CSA. The data were analysed using correlation tests and non-parametric tests, a multivariate linear regression and ROC tests. Results: A compressive cause was found by ultrasonography in 13 patients. The mean values of tt CSA and CSA were 20.1 ± 8.8 mm 2 [6-42] vs. 10.3 ± 2.3 mm 2 [8-14] (p = 0.0001) and 9.8 ± 6.7 mm 2 [0-29] vs. −0.2 ± 1.8 mm 2 [−3-4] (p < 0.0001) in the patients and the controls, respectively. The differences in CSA remained significant in the multivariate analysis after adjusting for age and weight. The best threshold for tt CSA in the TTS group was 15 mm 2 with 74% sensitivity and 100% specificity. The best threshold for CSA was 5 mm 2 with 81% sensitivity and 100% specificity. Discussion: The difference in the measured axial CSA of the tibial nerve by ultrasonography between the posteromedial tarsal tunnel and 10 cm above the tunnel is a key data point for the diagnosis of tarsal tunnel syndrome with and without compressive etiology. Level of evidence: III, diagnostic case-control study.
Clinical and electrophysiological findings and follow-up in tarsal tunnel syndrome
1998
The authors report clinical and electrophysiological findings in 59 patients with tarsal tunnel syndrome (TTS) and follow-up in 23 of them. The entrapment was prevalent in females; was bilateral in 6 patients and involved medial plantar in 7 and lateral plantar nerves in two cases. Eleven presented with other nerve entrapment syndromes or focal mononeuropathies, due to hereditary neuropathy with liability to pressure palsy or systemic diseases. The other 48 subjects had TTS without any other related entrapment syndromes: 23 were idiopathic cases, 13 had a history of local trauma, 3 had systemic diseases and the others had external or intrinsic compressions. The most frequent symptoms were paraesthesia or dysaesthesia (86% of feet) and pain (55%). Hypoaesthesia of the sole and weakness of toe flexion were evident in 74% and 22% of feet, respectively. Absence of sensory action potential or slowing of sensory conduction velocity (SCV) of the plantar nerves were present in 77% of feet; significant differences of SCV between affected and unaffected plantar nerves and/or between distal sural and plantar nerves were evident in 14%. Abnormalities of plantar SCV were therefore absent in only 9% of feet. Distal motor latency was delayed in 55% and electromyography showed neurogenic changes in 45% of sole muscles. Five cases (6 feet) underwent surgery with excellent or good results in 5, 4 of them also showing improvement in distal conduction of the plantar nerves. Nine were treated with local steroid injections, with good results shown in 6 patients. Nine other patients who did not receive any therapy showed a disappearance of symptoms or good outcome in 6 cases. The subjects with poor therapeutic results had S1 radiculopathy or systemic diseases. The authors underline that patients with connective tissue diseases should not be treated by surgical decompression because they may have subclinical neuropathy. Some subjects with idiopathic or trauma-induced TTS recover spontaneously. Surgical release should be limited to cases with space-occupying lesions and when conservative treatments fail.