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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2002 December;53(4):219-26
Tarsal tunnel syndrome: surgical experience over 10 years
Branca Vergano L., Manfredini S., Pastorelli G. M., Tian E.
Background. Tarsal tunnel syndrome is an entrapment neuropathy caused by the impingement of the posterior tibial nerve and of his branches within the tarsal tunnel. Its clinical features are pain and paresthesia at the sole of the foot and at the medial aspect of the ankle; only in advanced situations we can have muscle weakness and skin anesthesia.
Methods. A total of 44 patients (46 feet) operated in our Department in a period of 10 years (1992-2001) have been studied in order to evaluate the results obtained. The etiology of the syndrome was also studied to find the best diagnostic-therapeutic iter for this disease. The patients, were carefully examined and submitted to radiographic study of the foot and electrodiagnostic study of the posterior tibial nerve before surgery.
Results. Positive results, after surgery, were obtained in more than 80% of cases, while unsatisfactory results in the remaining cases. The etiology was equally subdivided in primary secondary, in particular as space-occupying and post-traumatic lesions. Non-surgical treatment was ineffective, while surgery was successful in most of the cases.
Conclusions. On the basis of these results, the effectiveness of the corrent and timely surgical treatment is underlined, if there is an appropriate clinical and electrophysiological diagnosis. In fact, the cause of our unsuccessful cases were an incorrect indication, rather than an incorrect surgical technique.