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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2001 March;25(1):41-8
Tarsal tunnel syndrome. Clinical analysis and long-term results of surgical treatment
Taglialavoro G., Postorino A., Candiotto S., Negrin P., Scapinelli R.
The authors analyse the most important etiopathogenetic aspects of Tarsal Tunnel syndrome (TTS) and report the immediate and long-term results of surgical treatment on the basis of their clinical experience at the Orthopedic Clinic of Padua University. They use a retrospective analysis of patients treated between 1991 and 1998 (32 patients) to compare the degree of neuropathy diagnosed clinically and electromyographically before and after surgery with a mean follow-up of 26 months. Intraoperative findings, mainly in the form of perineural fibrosis, hypertrophy of the laciniate ligament and venous ectasia, generate the suspicion that neuropathy may be part of a more generalised pathological context, involving the whole medial retromalleolar region of the foot. Peripheral neuropathy was only sustained by extrinsic compression of the nerve trunks in one case. TTS surgery, which is straight forward and low risk, failed to produce the immediate clinical results that are usually found in carpal tunnel syndrome. A marked clinical improvement was observed some time after the operation in all patients undergoing surgery with varying results, probably depending on the time between the onset of disease and the date of the operation, and the extent of neuropathy at the time of surgery. The clinical improvement of neuropathy may gradually lessen over time, above all in the most severe cases owing to irreversible chronic damage of the nerve trunks.