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Foot Ankle Surg 2022 Apr 29. Epub 2022 Apr 29.

Sheffield Teaching Hospitals NHS Foundation Trust, UK.

Iatrogenic nerve injury to the tibial nerve is a serious but avoidable complication of total ankle replacements and may be under-reported as it may go unrecognised or thought to be due to tarsal tunnel syndrome. The tibial nerve is particularly vulnerable during the saw cuts at the posteromedial corner without appropriate protection. Prior to drilling the tibial and talar pins of the adjustment block for the Infinity ankle replacement we perform a 2 cm incision behind the medial malleolus. Read More

Skeletal Radiol 2022 May 13. Epub 2022 May 13.

Radiology Department, Royal National Orthopaedic Hospital, Stanmore, UK.

Tarsal tunnel syndrome (TTS) is an entrapment neuropathy of the tibial nerve (TN) within the tarsal tunnel (TT) at the level of the tibio-talar and/or talo-calcaneal joints. Making a diagnosis of TTS can be challenging, especially when symptoms overlap with other conditions and electrophysiological studies lack specificity. Imaging, in particular MRI, can help identify causative factors in individuals with suspected TTS and help aid surgical management. Read More

Foot Ankle Surg 2022 Mar 31. Epub 2022 Mar 31.

The Orthopaedic Foot and Ankle Unit, Netcare Linksfield Hospital, Johannesburg, South Africa; Department of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa.

Interdigital neuroma is one of the commonest causes of metatarsalgia. The reported success rate after excision of a primary neuroma is 74%. Recurrent symptoms after neurectomy can be due to a recurrent interdigital neuroma. Read More

Clin Anat 2022 Apr 6. Epub 2022 Apr 6.

Department of Radiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.

We aimed to investigate the bone and soft tissue changes accompanying tarsal coalition (TC) and aimed to evaluate their association with the location and type of coalition. Ankle magnetic resonance imagings of 65 patients with TC were included. The relationship between the location and type of coalition and bone marrow edema, subchondral cysts, sinus tarsi syndrome, tarsal tunnel syndrome, posterior impingement syndrome, accessory bone, tibiotalar effusion, talar osteochondritis dissecans, ganglion cysts, and calcaneal spur were evaluated. Read More

Surg Radiol Anat 2022 Mar 30. Epub 2022 Mar 30.

Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Beirut, Lebanon.

Purpose: Many etiologies are known to lead to a tarsal tunnel syndrome (TTS). One rare cause is mass-occupying lesions, and particularly accessory or variant muscles (AVM). This study aimed to systematically collect published clinical cases of TTS caused by AVM. Read More

Cureus 2022 Feb 15;14(2):e22248. Epub 2022 Feb 15.

Anatomical Sciences, St. George's University, St. George's, GRD.

The posterior tibial vein (PTV) is formed distally by the medial and lateral plantar veins and ends proximally at the joining with the peroneal vein. Variations of the PTV can result in unique clinical presentations. Such variations at the proximal location have been classified previously, but few have been identified distally. Read More

Clin J Sport Med 2022 05 21;32(3):e316-e318. Epub 2022 Mar 21.

Radiology, Michigan State University, Lansing, Michigan.

Abstract: Tarsal tunnel syndrome (TTS) typically occurs from extrinsic or intrinsic sources of compression on the tibial nerve. We present 3 cases of patients, all of whom have a prolonged time to diagnosis after evaluation with multiple specialties, with foot pain ultimately secondary to an accessory flexor digitorum longus muscle causing TTS. The literature describing the association between TTS and accessory musculature has been limited to single case reports and frequently demonstrate abnormal electrodiagnostic testing. Read More

Arch Bone Jt Surg 2022 Jan;10(1):112-116

The Orthopaedic Foot and Ankle Unit, Netcare Linksfield Hospital, Johannesburg, South Africa.

Tarsal tunnel syndrome (TTS) is a relatively uncommon nerve entrapment neuropathy. Many pathologies are reported as possible causes for TTS. The diagnosis of TTS can be difficult and often missed. Read More

Rev Esp Cir Ortop Traumatol 2022 Jan-Feb;66(1):T23-T28

Equipo Tobillo y Pie, Clínica Santa María, Santiago, Chile.

Background: Retrospective review of patients with a diagnosis of Tarsal Tunnel Syndrome (TTS) treated surgically.

Methods: Retrospective series of patients with diagnosis of TTS operated between 2005 and 2020 in the same center. Variables such as age, sex, side, affected nerve or branch, classification, type of imaging study, biopsy result, infection rate, recurrence rate, sequelae, among others, were analyzed. Read More

Turk J Phys Med Rehabil 2021 Dec 1;67(4):421-427. Epub 2021 Dec 1.

Mehtap Kalçık Ünan, Özge Ardıçoğlu, Nevsun Pıhtılı Taş, Rabia Aydoğan Baykara, Ayhan Kamanlı.

Objectives: In this study, we aimed to determine the frequency of tarsal tunnel syndrome (TTS) in rheumatoid arthritis (RA) patients.

Patients And Methods: Thirty RA patients (1 male, 29 females; mean age: 41.9±10. Read More

Case Rep Neurol Med 2021 12;2021:7161757. Epub 2021 Nov 12.

University of Michigan, Ann Arbor, USA.

Compressive tibial mononeuropathies are uncommon and can be caused by conditions including posterior compartment syndrome, soleal sling syndrome, and tarsal tunnel syndrome. Therefore, it is critical to consider noncompressive etiologies when a tibial mononeuropathy is suspected. This is a patient with a history of rare inherited immune dysregulation that presented to the electrodiagnostic laboratory with severe neuropathic pain in the right foot associated with plantarflexion weakness, concerning for a tibial mononeuropathy. Read More

J Foot Ankle Surg 2022 May-Jun;61(3):583-589. Epub 2021 Oct 23.

Neurologist, Cabinet de rhumatologie, Lyon, France.

Surgical results in tarsal tunnel syndrome are variable, and etiology seems to be a factor. Three possible etiologies can be distinguished. The aim of the present study was to compare surgical results according to etiology. Read More

Neurol Med Chir (Tokyo) 2022 Feb 10;62(2):75-79. Epub 2021 Nov 10.

Department of Neurological Surgery, Nippon Medical School Hospital.

Peripheral nerve diseases are common. Para-lumbar spine diseases (PLSDs) include peripheral neuropathy around the lumbar spine, e.g. Read More

Orthop Traumatol Surg Res 2022 02 20;108(1S):103121. Epub 2021 Oct 20.

Service de Chirurgie Orthopédique, Hôpital Trousseau, CHRU de Tours, avenue de la République, Chambray-lès-Tours, 37044 Tours cedex 9, France; Faculté de Médecine de Tours, 10, boulevard Tonnellé, 37032 Tours cedex 1, France. Electronic address:

Calcaneal osteotomy is an extra-articular procedure used for conservative surgical treatment of hindfoot deformity. It has static, architectural and dynamic effects, reorienting the tuberosity action point of the digastric muscle formation of the sural triceps and plantar aponeurosis. Calcaneal osteotomies vary in location, form and displacement, but can be categorized as tuberosity osteotomy, acting on talar position, and cervical osteotomy, acting on Chopart joint-line orientation. Read More

Yeungnam Univ J Med 2021 Oct 5. Epub 2021 Oct 5.

Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea.

Surg Radiol Anat 2021 Dec 24;43(12):2083-2086. Epub 2021 Sep 24.

Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, 02118, USA.

Purpose: During standard anatomical dissection for a medical anatomy course, we encountered an unusual bilateral variant of a unipennate flexor digitorum accessorius longus (FDAL) muscle, a supernumery muscle of the deep posterior leg and medial ankle.

Methods: We documented the muscles course and measured the diameter and length of the FDAL muscle belly, as well as the full length of its tendinous attachments.

Results: On both right and left legs, the FDAL originated from the proximal posterior fibula and distal one-third of the flexor hallucis longus muscle. Read More

Cureus 2021 Jul 30;13(7):e16761. Epub 2021 Jul 30.

Physical Medicine and Rehabilitation, Genesis Health System, Davenport, USA.

This case report involves a 17-year-old male referred for electrodiagnostic (EDX) evaluation with symptoms of tarsal tunnel syndrome after being stung by a stingray. EDX testing revealed moderate axonal injury localized to the tarsal tunnel. Subsequent exploratory surgery removed a stingray barb from the tarsal tunnel. Read More

Plast Reconstr Surg 2021 Sep;148(3):592-596

From the Department of Plastic and Reconstructive Surgery, Saga University Hospital; Department of Orthopaedic Surgery, Toride-Kitasouma Medical Association Hospital; and Okutsu Minimally Invasive Orthopaedic Clinic.

Background: Dellon et al. have reported that chronic nerve compression of the tibial nerve inside the tarsal tunnel, caused by diabetes mellitus, can be relieved following open decompression surgery. However, the large skin incision resulting from Dellon's procedure may cause wound healing problems. Read More

Ann Transl Med 2021 Jul;9(13):1104

Department of Orthopaedic Surgery, Texas Scottish Rite Hospital, Dallas, TX, USA.

Despite the widespread use of the Ponseti method for treatment of clubfeet, there continue to be a significant number of patients who present with a severe, stiff clubfoot as a result of extensive intra-articular soft tissue release or lack of access to care. In such patients, circular external fixators can be utilized for deformity correction with distraction across soft tissues, joints, and osteotomies. Ilizarov or hexapod circular fixators may be utilized according to surgeon preference. Read More

J Ultrasound Med 2022 May 3;41(5):1247-1272. Epub 2021 Aug 3.

Hôpital de la Pitié-Salpêtrière, Service de Radiologie, Paris, France.

Tarsal tunnel syndrome may be idiopathic or may be caused by various conditions: bone disease, thickening of the retinaculum, hematoma, or iatrogenic nerve damage; tendinopathy or tenosynovitis; the presence of supernumerary muscles such as an accessory soleus, peroneocalcaneus internus, or accessory flexor digitorum muscle; bone or joint disorders; expansile tumors or cysts; and venous aneurysm or kinking of the tibial artery. The purpose of this article is to describe and illustrate most of the causes of tarsal tunnel syndrome, as diagnosed by ultrasound, which is a practical, inexpensive method. Read More

J Brachial Plex Peripher Nerve Inj 2021 Jan 27;16(1):e37-e45. Epub 2021 Jul 27.

Department of Orthopaedics, College of Osteopathic Medicine, Henry Ford Macomb Hospital, Michigan State University, Clinton Twp., Michigan, United States.

 The relationship between tarsal tunnel syndrome (TTS), electrodiagnostic (Edx) findings, and surgical outcome is unknown. Analysis of TTS surgical release outcome patient satisfaction and comparison to Edx nerve conduction studies (NCSs) is important to improve outcome prediction when deciding who would benefit from TTS release.  Retrospective study of 90 patients over 7 years that had tarsal tunnel (TT) release surgery with outcome rating and preoperative tibial NCS. Read More

J Clin Med 2021 Jul 11;10(14). Epub 2021 Jul 11.

Department of Nursery and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain.

Background: Tarsal tunnel syndrome (TTS) is one of the most common entrapment syndromes. Although diagnosis is supported by imaging tests, it has so far been based on clinical findings. Neurophysiological tests are not effective for providing an accurate diagnosis. Read More

Arthrosc Tech 2021 Jun 24;10(6):e1615-e1619. Epub 2021 May 24.

North District Hospital, Sheung Shui, NT, Hong Kong SAR, China.

A ganglion inside the tarsal tunnel can compress the tibial nerve, leading to posterior tarsal tunnel syndrome. Classically, the ganglion is resected with an open approach. This requires release of the flexor retinaculum and dissection around the tibial neurovascular bundle, which may induce fibrosis around the tibial nerve. Read More

Morphologie 2021 Jul 8. Epub 2021 Jul 8.

Department of Mathematics, Manipal Institute of Technology, Manipal Academy of Higher Education, Madhav Nagar, Manipal, Karnataka State, 576104, India. Electronic address:

Flexor digitorum accessorius (quadratus plantae) is a muscle of second layer of the sole of the foot. Though it is not a very important muscle in terms of movements or stability of foot, it could pose problems when it presents variations. We observed a novel, accessory slip of flexor digitorum accessorius. Read More

Foot Ankle Surg 2021 Jul 3. Epub 2021 Jul 3.

Department of Rheumatology, Hospices Civils de Lyon, University Hospital Lyon Sud, Pierre-Bénite, France; University of Lyon 1, Lyon, France. Electronic address:

Background: Factors that may affect surgical decompression results in tarsal tunnel syndrome are not known.

Methods: A retrospective single-center study included patients who had undergone surgical tibial nerve release. The effectiveness of decompression was evaluated according to whether the patient would or would not be willing to undergo another surgical procedure in similar preoperative circumstances. Read More

Med Hypotheses 2021 Aug 24;153:110638. Epub 2021 Jun 24.

Unit of Hand Surgery and Microsurgery, University Hospital of Modena, Modena, Italy.

COVID-19 is a complex disease with many clinicopathological issues, including respiratory, gastrointestinal, neurological, renal, cutaneous, and coagulative ones; in addition, reactive arthritis has been reported by different authors. Here, we hypothesize that a peripheral microangiopathy involving nerve supply, a viral demyelination, or an immune-mediated irritating antigenic stimulus on synovial sheaths after SARS-CoV-2 infection may all induce a carpal, cubital or tarsal tunnel syndrome of variable entity in genetically predisposed subjects associated with myxoid nerve degeneration. Read More

Arch Rheumatol 2021 Mar 14;36(1):107-113. Epub 2021 Jan 14.

Department of Neurology, Konyang University College of Medicine, Daejeon, South Korea.

Objectives: This study aims to evaluate the frequency of tarsal tunnel syndrome (TTS) in fibromyalgia (FM) patients.

Patients And Methods: In this prospective study, we investigated paresthesia of the foot, sensory and motor deficits, atrophy of the abductor hallucis muscle, and the presence of Tinel's sign in 76 female FM patients (mean age 39.3±7. Read More

Foot (Edinb) 2021 Jun 8;47:101797. Epub 2021 Apr 8.

Northwestern Memorial Hospital, Chicago, IL, USA.

Displaced isolated fractures of sustentaculum tali are rare. Inadequate treatment of these injuries can rarely lead to non-union or mal-union and in most cases are treated non-surgically. We report a unique case of undiagnosed mal-union of sustentaculum tali in the setting of underlying tarsal coalition that resulted in symptoms of tarsal tunnel. Read More

Foot (Edinb) 2021 Jun 8;47:101800. Epub 2021 Apr 8.

School of Electrical and Computer Engineering, University of Campinas, Campinas, SP, Brazil. Electronic address:

Background: Valgus hindfoot is a very common postural deviation, and the associated foot pronation can be a triggering factor for diseases such as tarsal tunnel syndrome.

Research Question: This work compares two techniques for hindfoot valgus correction: GPR (Global Postural Reeducation) and PIMT (Postural Integration by Manual Therapy).

Methods: Sixty young adult subjects from the Brazilian Army with unilateral hindfoot valgus were selected and divided into two groups of 30 subjects, one treated with GPR and the other treated with PIMT. Read More

Rev Esp Cir Ortop Traumatol 2022 Jan-Feb;66(1):23-28. Epub 2021 May 2.

Equipo Tobillo y Pie, Clínica Santa María, Santiago, Chile.

Background: Retrospective review of patients with a diagnosis of Tarsal Tunnel Syndrome (TTS) treated surgically.

Methods: Retrospective series of patients with diagnosis of TTS operated between 2005 and 2020 in the same center. Variables such as age, sex, side, affected nerve or branch, classification, type of imaging study, biopsy result, infection rate, recurrence rate, sequelae, among others, were analyzed. Read More