Tarsal Tunnel Syndrome

The tarsal tunnel syndrome consists of a complex of symptoms affecting the foot and is thought to be due to a compression neuropathy of the posterior tibial nerve within the fibro-osseous “ tunnel “ that lies beneath the flexor retinaculum on the medial side of the ankle. No comprehensive description of this condition can be found until 1962, when two isolated cases were reported (Keck 1962, Lam 1962). In both these cases extensive operative decompression and mobilisation of the posterior tibial nerve resulted in complete relief of symptoms. During the past two years two further cases have been reported (Kojima 1963, McGill 1964). With increasing awareness of this condition the diagnosis has been made earlier, often before the development of objective sensory or motor paralysis. Earlier reports of the now familiar carpal tunnel syndrome concerned themselves with advanced cases showing marked motor and sensory disturbance and with pathological changes evident in the median nerve at operation (BraAn, Wright and Wilkinson 1947; Fisher 1954). Nowadays the carpal tunnel syndrome is sufficiently well recognised to ensure that most cases are treated before this stage is reached. The same pattern of events may evolve in the case of the tarsal tunnel syndrome.