Anterior Tarsal Tunnel Syndrome

NewsBot · May 30, 2015

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Treatment of Anterior Tarsal Tunnel Syndrome through an Endoscopic or Open Technique
Mustafa Yassin, Avraham Garti, Moshe Weissbrot, Eyal Heller, Dror Robinson
The Foot; Article in Press

Highlights
•Endoscopic technique is used to visualize and decompress the nerve.
•Indications for endoscopic procedure are a well-defined imaging abnormality
•Typical imaging pathologies are osteophytes, ganglions or localized synovitis.
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Anterior tarsal tunnel syndrome is often underdiagnosed, due to lack of clinical awareness and vague clinical presentation. Most often patients complain of pain located to the dorsum of the foot. The present study is a consecutive series of 13 patients treated according to a fixed protocol followed for 24 months at least. A total of 12/13 cases presented with a bulge in the anterior part of the ankle or the dorsal foot and Tinel's sign was positive over it. Only half had decreased sensation. Surgical technique was either endoscopic or open. Endoscopy is preferable when compression is due to an osteophyte (4/13) or an isolated ganglion 2/13). In other cases presenting with synovitis (5/13) or unknown etiology (2/13) performing open surgery was deemed as safer.

The American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scores improved from an average of 55 ± 8 to 83 ± 11 at 12 months after surgery and 88 ± 10 at 24 months after surgery.

The anterior tarsal tunnel syndrome accounts for approximately 5% of cases complaining of feet numbness, which undergo electromyographic and nerve conduction testing. Reports in the scientific literature are scarce, perhaps due to underdiagnoses, while it is amenable to surgical management. Clinical diagnosis supported by imaging studies demonstrated osteophytes, ganglions or localized synovitis. Endoscopic treatment can be performed safely provided a clear cut single compressing element is identified.
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NewsBot · Apr 18, 2018

Muscular Variations of Extensor Digitorum Brevis Muscle Related with Anterior Tarsal Tunnel Syndrome
Hyung-Jin Won and Chang-Seok Oh
Korean J Phys Anthropol. 2018 Mar;31(1):35-39. Korean.

During routine dissection, additional muscular head of extensor digitorum brevis muscle attaching to the third toe and accessory muscle perforated by the branch of the deep peroneal nerve were observed in the right foot of a 71-year-old male cadaver. The additional muscular head originated from the dorsal surface of cuboid bone, and ran parallel with the third tendon of the extensor digitorum brevis muscle. It was conjoined with the third tendon of extensor digitorum brevis at the middle of its course. The accessory muscle was a small muscle which was covered with the muscle belly of the extensor hallucis brevis muscle. It originated from the dorsal surface of the calcaneus, and inserted to the lateral one-third of transverse retinacular band. These two variants were innervated by the branches of deep peroneal nerve. The branches of deep peroneal nerve were compressed under the tendon of extensor hallucis brevis and around the site where the nerve branch perforated the small muscle. The clinical significances of these variations and tendon of extensor hallucis brevis muscle were discussed.
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NewsBot · Jan 1, 2024

Anterior Tarsal Tunnel Syndrome: Entrapment of the Articular Branch of Deep Peroneal Nerve: A Case Report
Pradeep Moonot et al
JBJS Case Connect. 2023 Dec 8;13(4)

Case: A 28-year-old male patient who injured his ankle 2 years ago presented with unilateral ankle pain, tingling, and numbness for 1 year. Clinically, tenderness and positive Tinel sign were localized on anterior aspect of ankle. On exploration, deep peroneal nerve and mainly its articular branch were encased in fibrotic tissue. Decompression of both nerves resulted in symptomatic relief after surgery.

Conclusion: High index of suspicion, a thorough medical history, meticulous clinical examination, complete knowledge of nerve anatomy, proper radiological studies, and careful surgical decompression are all necessary for the diagnosis and management of such atypical cases.
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NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

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