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If non-invasive treatment measures fail, tarsal tunnel release surgery may be recommended. Tarsal tunnel release is a form of a nerve decompression to relieve pressure on the tibial nerve. The incision is made behind the ankle bone and then down towards but not as far as the bottom of foot.
Tarsal tunnel syndrome is the most commonly reported nerve entrapment of the ankle. It is analogous to carpal tunnel syndrome in the wrist. It is caused by compression of the tibial nerve underneath the flexor retinaculum of the foot. [1] People with tarsal tunnel syndrome have pain in the plantar aspect of the foot mostly at night.
Nerve decompressions are still a relatively new surgery, however a picture emerges from looking at the outcomes of some of the most studied nerve decompressions: carpal tunnel release, sciatic nerve decompression, and migraine surgery. Even within these commonly performed surgeries, the measurement of outcomes is not always standardized.
The flexor retinaculum of the foot extends from the medial malleolus above, to the calcaneus below. [1] This converts a series of bony grooves into canals for the passage of the tendons of the flexor muscles and the posterior tibial vessels and tibial nerve into the sole of the foot, known as the tarsal tunnel.
The development of carpal tunnel syndrome was of particular interest for other idiopathic tardy nerve palsies. Carpal tunnel served as a model for how nerves could be squeezed by narrow anatomic compartments and soon other tunnel syndromes were conceptualized, such as cubital tunnel syndrome, and tarsal tunnel syndrome. [87] [88] [83]
Sinus tarsi syndrome is the clinical disorder of pain and tenderness in the sinus tarsi, which is a lateral tunnel in the foot at the junction of the hindfoot and the midfoot, between the ankle and the heel. [1] [2] Most of the time, sinus tarsi syndrome onsets after ankle sprains, however there can be other causes. [3]
It is named after Jules Tinel. [ 3 ] [ 4 ] [ 5 ] It is a potential sign of carpal tunnel syndrome , cubital tunnel syndrome , [ 6 ] anterior tarsal tunnel syndrome [ 7 ] [ 8 ] and symptomatic neuroma .
The flexor hallucis longus is situated on the fibular side of the leg. It arises from the inferior two-thirds of the posterior surface of the body of the fibula, with the exception of 2.5 cm at its lowest part; from the lower part of the interosseous membrane; from an intermuscular septum between it and the peroneus muscles, laterally, and from the fascia covering the tibialis posterior, medially.
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