1/63. Anterior entrapment syndromes. The anterior tarsal tunnel syndrome is best described as a chronic irritation or compression of the deep peroneal nerve. The pathogenesis, etiology, and diagnostic features of the anterior tarsal tunnel as it effects the foot are discussed with its complexities. Case histories are presented. ( info) |
| Anterior tarsal tunnel syndrome is a rare entrapment neuropathy involving the deep peroneal nerve beneath the inferior extensor retinaculum of the ankle and foot. This syndrome may be a clinically under-recognized entity, thus making a missed diagnosis and delayed treatment likely. We present the case of a 53-year-old woman who for many years had experienced the clinical symptoms of anterior tarsal tunnel syndrome, including pain in the dorsum of the right foot with numbness radiating to the first web space. Roentgenograms of the foot revealed osteophytes on the dorsum of the talus as it articulated with the navicular bone. During surgery, the osteophytes were found to be irritating the deep peroneal nerve. After surgical decompression of the anterior tarsal tunnel, the patient had a significant reduction of symptoms. One year later, she was noted to be asymptomatic with normal physical findings. We believe that this case points to the necessity of more thoughtful attention to this syndrome and its diagnosis. That is to say, a thorough knowledge of the pathogenesis and a comprehensive physical examination are the prerequisites for correct diagnosis and appropriate treatment. ( info) |
3/63. Common painful foot syndromes. The prevalence of foot problems in the general population is 10%, and in the elderly it ranges from 53% to 95%. Proximal plantar fasciitis is the most common cause of painful feet in clinical practice, and is twice as common among women as among men. metatarsalgia is probably the most common cause of foot pain among middle-aged women. ( info) |
4/63. The accessory soleus and recurrent tarsal tunnel syndrome: case report of a new surgical approach. The accessory soleus muscle is a rare anatomic variant, which presents as a mass in the posteromedial aspect of the ankle. This anomaly has been linked with compression neuropathy of the posterior tibial nerve. The authors present a case of tarsal tunnel syndrome in which the presence of an accessory soleus was unrecognized at the time of the original procedure, but was utilized during the revisional operation to provide safe coverage of the posterior tibial nerve. ( info) |
| tarsal tunnel syndrome is a well-known but rare entrapment neuropathy involving the posterior tibial nerve in the tarsal tunnel, a fibro-osseous channel extending from the medial aspect of the ankle to the midfoot. Posttraumatic fibrosis, ganglion cyst, tenosynovitis, tumor of the nerves or other structures, dilated or tortuous veins can cause significant nerve compression in this anatomic region. Herein, we present the typical ultrasonographic and magnetic resonance features of this disorder in patient with a ganglion cyst. ( info) |
6/63. Hypertrophic sustentaculum tali causing a tarsal tunnel syndrome: a case report. A case report of tarsal tunnel syndrome caused by a hypertrophic sustentaculum tali is presented. This is the first reported case secondary to this etiology. Complete resolution of the patient's symptoms has been obtained through resection of the hypertrophic anatomy. The authors also discuss possible etiologies of tarsal tunnel syndrome. ( info) |
7/63. tarsal tunnel syndrome secondary to neurilemoma--a case report. Peripheral nerve entrapment syndromes in the foot include those symptom complexes that are primarily neurologic in origin and result from embarrassment to any of the peripheral nerve trunks or branches of the foot. tarsal tunnel syndrome usually is precipitated by compression of the tibial nerve posterior and distal to the medial malleolus. A neurilemoma is relatively uncommon in the foot. It is usually a solitary tumor that is almost exclusively benign and can be removed without jeopardizing the integrity of the nerve. diagnosis is based on a thorough history and clinical pictures. Certain diagnostic modalities, ultrasound and MRI, have been employed to aid in diagnosis. Surgical excision of the tumor remains the treatment of choice. ( info) |
8/63. tarsal tunnel syndrome secondary to an accessory muscle: a case report. The flexor digitorum accessorius longus is a rare muscular anomaly that has been reported as one of the etiologies of tarsal tunnel syndrome. The authors provide a case report of a patient with tarsal tunnel syndrome that resolved with resection of the flexor digitorum accessorius longus. The patient remains asymptomatic 40 months following surgery. ( info) |
| tarsal tunnel syndrome caused by talocalcaneal coalition is uncommon. We presented the ultrasonography (US) and magnetic resonance imaging findings of this disease. This is, to our knowledge, the first case report describing the US findings in tarsal tunnel syndrome caused by talocalcaneal coalition. ( info) |
10/63. Acute tarsal tunnel syndrome following partial avulsion of the flexor hallucis longus muscle: a case report. An acute posterior tibial nerve compression from a partially ruptured flexor hallucis longus (FHL) muscle is reported. This etiology for acute tarsal tunnel syndrome has not been previously described. A 17-year-old male sustained multiple injuries in a motor vehicle accident, including a tibial shaft fracture and a posterior medial right ankle laceration of the same limb. The injured limb had no sensation on the plantar aspect of the foot and heel, decreased active great toe flexion, and associated leg pain. Exploration of the posterior tibial nerve for presumed laceration revealed the nerve to be intact, but compressed in a tense tarsal tunnel from a retracted partially ruptured flexor hallucis longus tendon. decompression of the tunnel and resection of the devascularized muscle resulted in complete neurologic recovery. ( info) |