Abstract
Tarsal tunnel syndrome is defined as entrapment of the posterior tibial nerve at the level of the ankle. The syndrome has been associated with traumatic inflammatory etiologies. The diagnosis is made clinically by the presence of dysesthesia in the distribution of the medial and lateral plantar nerves, a positive Tinel's sign, paresthesias with compression of the nerve at the tarsal tunnel, tenderness of the nerve along its course (Valleix Phenomenon), and sensory or motor changes. Most authors suggest surgical decompression for the treatment of tarsal tunnel syndrome. The purpose of this review is to summarize the etiologies of tarsal tunnel found in the literature, to evaluate the current role of electrodiagnosis in the diagnosis of tarsal tunnel syndrome and to examine the results of treatment modalities presented.
Get full access to this article
View all access options for this article.
References
1.
.
Baylan
S.P.
Paik
S.W.
Barnert
A.L.
Ko
K.H.
Yu
J.
Persellin
R.H.
Prevalence of the tarsal tunnel syndrome in rheumatoid arthritis.
Rheum. Rehab. , 20 (3 ):148 –150 , 1981 .
2.
.
Buchthal
F.
Rosenfalck
A.
Evoked action potentials and conduction velocity in human sensory nerves.
Brain Research , 3 : 1 –122 , 1966 .
3.
.
Byrd
J.W.
Ricciardi
J.M.
Jung
B.I.
Regional migratory osteoporosis and tarsal tunnel syndrome.
Clin. Orthop. , 157 : 164 –169 , 1981 .
4.
.
Chater
E.H.
Tarsal-tunnel syndrome in rheumatoid arthritis.
Br. Med. J. , 3 (719 ):406 , 1970 .
5.
.
DeLisa
J.A.
Saeed
M.A.
The tarsal tunnel syndrome. Muscle and Nerve, 664–670, 1983 .
6.
.
Dellon
A.L.
MacKinnon
S.E.
Tibial nerve branching in the tarsal tunnel.
Arch. Neurol. , 41 : 645 –646 , 1984 .
7.
.
Distefano
V.
Sack
J.T.
Whittaker
R.
Nixon
J.E.
Tarsal-tunnel Syndrome: review of the literature and two case reports.
Clin. Orthop. , 88 : 76 –79 , 1972 .
8.
.
Edwards
W.G.
Lincoln
C.R.
Bassett
F.H.
III
Goldner
J.L.
The tarsal tunnel syndrome: diagnosis and treatment.
J.A.M.A. , 207 (4 ):716 –720 , 1969 .
9.
.
Enright
T.
Liang
G.C.
Fox
T.A.
Mueller
R.F.
Tarsal tunnel syndrome with ankylosing spondylitis.
Arthritis Rheum. , 21 : 77 , 1979 .
10.
.
Fahlund
G.T.R.
Suture of the posterior tibial nerve below the knee with a followup study of the clinical results.
J. Neurosurg. , 3 : 223 –233 , 1946 .
11.
.
Francis
H.
March
L.
Terenty
T.
Webb
J.
Benign joint hypermobility with neuropathy: documentation and mechanism of tarsal tunnel syndrome.
J. Rheumatology , 14 (3 ):577 –581 .
12.
.
Fu
R.
DeLisa
J.A.
Kraft
G.H.
Motor latencies through the tarsal tunnel in normal adult subjects: Standard determinations corrected for temperature and distance.
Arch. Phys. Med. Rehabil. , 61 : 243 –248 , 1980.
13.
.
Goodgold
J.
Kopell
H.P.
Speilholz
N.A.
The tarsal tunnel syndrome: objective diagnostic criteria.
N. Engl. J. Med. , 273 (14 ):742 –745 , 1965 .
14.
.
Gould
N.
Alvarez
R.
Bilateral tarsal tunnel syndrome caused by varicosities.
Foot Ankle , 3 (5 ):290 –292 , 1983 .
15.
.
Grabois
M.
Puetes
J.
Ludsky
M.
Tarsal tunnel syndrome in rheumatoid arthritis.
Arch. Phys. Med. Rehab. , 62 : 401 –403 , 1981 .
16.
.
Guiloff
R.J.
Sherratt
R.M.
Sensory conduction in the medial plantar nerve.
J. Neural. Neurosurg. Psychiatry , 40 : 1168 –1181 , 1977 .
17.
.
Hammerschlag
W.A.
Goldner
J.L.
Bassett
F.H.
Posterior tibial nerve entrapment: a thirty-three year review. Am. Orthop. Foot Ankle Soc., July 1988 .
18.
.
Havel
P.E.
Ebraheim
N.A.
Clark
S.E.
Jackson
W.T.
DiDio
L.
Tibial branching in the tarsal tunnel.
Foot Ankle , 9 (3 ):117 –119 , 1988 .
19.
.
Heimkes
B.
Posel
P.
Stotz
S.
Wolf
K.
The proximal and distal tarsal tunnel syndromes: an anatomical study.
Intl. Orthop. , 11 (3 ):193 –196 , 1987 .
20.
.
Janecki
C.J.
Dovberg
J.L.
Tarsal-tunnel syndrome caused by neurilemoma of the medial plantar nerve: a case report.
J Bone Joint Surg. , 59A(1) : 127 –128 , 1977 .
21.
.
Johnson
E.W.
Ortiz
P.R.
Electrodiagnosis of tarsal tunnel syndrome.
Arch. Phys. Med. Rehabil. , 47 : 776 –780 , 1966 .
22.
.
Kaplan
P.E.
Kernahan
W.T.
Tarsal tunnel syndrome: an electrodiagnostic and surgical correlation.
J Bone Joint Surg. , 63A(1) : 96 –99 , 1981 .
23.
.
Keck
C.
The tarsal tunnel syndrome.
J Bone Joint Surg. , 44A(1) : 180 –182 , 1962 .
24.
.
Kenzora
J.E.
Lenet
M.D.
Sherman
M.
Synovial cyst of the ankle joint as a cause of tarsal tunnel syndrome.
Foot Ankle , 3 (3 ):181 –183 , 1982 .
25.
.
Kopell
H.P.
Thompson
W.A.L.
Peripheral entrapment neuropathies of the lower extremity.
N. Engl. J. Med. , 262 : 56 –60 , 1960 .
26.
.
Lam
S.J.S.
Tarsal Tunnel Syndrome.
J. Bone Joint Surg. , 49B(1) : 87 –92 , 1967 .
27.
.
Langan
P.
Weiss
C.A.
Subluxation of the tibialis posterior, a complication of tarsal tunnel decompression: a case report.
Clin. Orthop. , 146 : 226 –227 , 1980 .
28.
.
Linscheid
R.L.
Burton
R.C.
Fredericks
E.J.
Tarsal tunnel syndrome.
Southern Med. J. , 63 (11 ):1313 –1323 , 1970 .
29.
.
Lloyd
K.
Agarwal
A.
Tarsal tunnel syndrome: a presenting feature of rheumatoid arthritis.
Br. Med. J. , 3 : 32 , 1970 .
30.
.
Mann
R.A.
Tarsal tunnel syndrome.
Proceeding of the American Orthopaedic Foot Society. Orthop. Clin. North Am. , 5 (1 ):109 –115 , 1974 .
31.
.
Matricali
B.
Tarsal tunnel syndrome caused by ganglion compression.
J. Neurosurg. Sci. , 24 : 183 –185 , 1980 .
32.
.
Menon
J.
Dorfman
H.D.
Renbaum
J.
Friendler
S.
Tarsal tunnel syndrome secondary to neurilemoma of the medial plantar nerve.
J. Bone and Joint Surg. , 62(A) : 301 –303 , 1980 .
33.
.
Myerson
M.
Soffer
S.
lipoma as an etiology of tarsal tunnel syndrome: a report of two cases.
Foot Ankle , 10 (3 ):176 –179 , 1989 .
34.
.
Nakano
K.K.
The entrapment neuropathies of rheumatoid arthritis.
Orthop. Clin. North Am. , 6 (3 ):837 –860 , 1975 .
35.
.
Oh
S.J.
Savaria
P.K.
Kuba
T.
Elmore
R.S.
Tarsal tunnel syndrome: electrophysiologic study.
Ann. Neurol. , 5 : 327 –330 , 1979 .
36.
.
O'Malley
G.M.
Lambdin
C.S.
McCleary
G.S.
Tarsal tunnel syndrome: a case report and review of the literature.
Orthopedics , 8 (6 ):758 –760 , 1985 .
37.
.
Pollock
L.J.
Davis
L.L.
Peripheral nerve injuries.
Am. J. Surg. , 18 : 361 –401 , 1932 .
38.
.
Ponsford
S.N.
Sensory conduction in medial and lateral plantar nerves.
J. Neurol. Neurosurg. Psychiatry , 51 : 188 –191 , 1988 .
39.
.
Radin
E.L.
Tarsal tunnel syndrome.
Clin. Orthop. , 181 : 167 –170 , 1983 .
40.
.
Saeed
M.A.
Gatens
P.F.
Compound nerve action potentials of the medial and lateral plantar nerves through the tarsal tunnel.
Arch. Phys. Med. Rehabil. , 63 : 304 –307 , 1982 .
41.
.
Sammarco
G.J.
Stephens
M.M.
Tarsal tunnel syndrome caused by the flexor digitorum accessorius longus.
J. Bone Joint Surg. , 72A(3) : 453 –454 , 1990 .
42.
.
Sarrafian
S.
Anatomy of the Foot and Ankle: Descriptive, Topographic, Functional . Philadelphia , Lippincott pp. 119 , 1983 .
43.
.
Srinivasan
R.
Rhodes
J.
Seidel
M.R.
The tarsal tunnel.
Mt. Sinai J. Med. , 47 (1 ):17 –23 , 1980 .
44.
.
Taguchi
Y.
Nosaka
K.
Yasuda
K.
Teramoto
K.
Mano
M.
Yamamoto
S.
The tarsal tunnel syndrome: report of two cases of unusual cause.
Clin. Orthop. , 217 : 247 –252 , 1987 .
45.
.
Ward
W.C.
Posterior tibial nerve injuries.
Southern Surgeon , 14 : 124 –129 , 1948 .
46.
.
Willemon
W.K.
Tarsal tunnel syndrome: a fifty year survey of the world literature and report of two cases.
Orthop. Rev. , 8 : 111 –117 , 1979 .