Clinical and Electrophysiological Findings in Tarsal Tunnel Syndrome

Abstract

Background: Tarsal tunnel syndrome [TTS] is a syndrome of which there's compression of posterior tibıal nerve or its branches under the flexor retinaculum at the ankle behind and below the medial malleolus. Electrophysiological diagnosis of TTS consists of motor, sensory and/or mixed nerve conduction studies. In this study 23 patients and 10 healthy volunteers were studied electrophysiologically. Objective: The aim of the study was to find out the types and frequencies of clinical signs and electrophysiological findings in TTS. Results: Paresthesis of the plan tar surface of the feet was the first line symptom with a percentage of 91 %. The second was foot aches [26 %]. The most frequent sign was the tinel sign positivity behind the medial malleolus of the foot [56.5%], the second was hypoesthesia in the plantar surface of the feet [17.39 %]. Twelve of the patients [52.2%] had TTS bilaterally while eleven of them had anterior tarsal tunnel syndrome [47.8%] and one carpal tunnel syndrome [4.3%] in addition to TTS. The most frequent electrophysiological abnormality in the patient group was absence of compound and sensory nerve action potentials in lateral plantar nerve [82.6%], while absence of CNAPand SNAP in medial plantar nerve followed this by a percentage of 45. 64%. Otherfindings were; slowing of motor nerve conduction velocity of posterior tibial nerve in the tarsal tunnel, delay in CNAP and SNAP latencies of medial plantar nerve and amplitude reduction in CNAP and SNAPs of medial plantar nerve [32. 60%]. In needLe EMG abductor hallucis longus involvement was 56 %, while abductor digiti quinti involvement was 50 %.