Médecine et chirurgie du pied


Surgery of tarsal tunnel: a report about four cases Volume 29, issue 2, Juin 2013


The tarsal tunnel syndrome is a rare disease. These symptoms include pain and plantar dysesthesia in the territory of the posterior tibial nerve. Existence of a Tinel sign on the path of the posterior tibial nerve is the best argument in favour of clinical compression. The electrophysiological study confirmed the diagnosis in the four cases. Imaging can help the etiological analysis looking for a lesion of the bone structure, the sequelae of fracture of the hindfoot, static disorders of the foot and the presence of any space-occupying intraductal lesions. Initial treatment is always medical; it combines analgesic and anti-inflammatory prescriptions. Sensory-motor rehabilitation is always indicated. The apparatus is indicated in case of static disorders of the foot. Surgery is indicated if conservative treatment fails or if there is a presence of a compressive lesion. It is based on the incision of the flexor retinaculum, the opening of the abductor hallucis muscle fascia and the tibial nerve neurolysis. The surgery must release all these structures to have good results and avoid recurrences in the long run.