Anatomy – Tarsal Tunnel

07/18/09 1
 Tarsal tunnel syndrome
 TTS is the most common
entrapment neuropathy affecting
the foot.
 Most frequent causes are
deformities of the foot, space-
occupying lesions, and incidental
trauma.

07/18/09 2
 Symptoms and Signs
 Insidious onset of burning pain
 Paresthesias that radiate from the

medial malleolus to the plantar aspect

of the foot.
 Positive Tinel's sign (the reproduction of

symptoms upon percussion along the

course of the posterior tibial nerve,
located just medially and inferior to the
medial malleolus)
 Pain in the region of the medial
07/18/09 4
 Diagnosis of TTS
 History and physical examination.
 Nerve conduction studies and plain
radiographs will further help in
confirming the diagnosis of TTS.
 Nerve conduction velocity and
electromyographic.
 Radiographic films will identify
displaced fractures and new extra bone
formation within the anatomy of the
tarsal tunnel.
07/18/09 5
 Dorsiflexion and Eversion

07/18/09 6
 Conservative Treatment
 Anti-inflammatory agents.
 Control of abnormal pronatory
forces.
 Foot orthotics
 Local injections of corticosteroids
into the third canal of the tarsal
tunnel to decrease pain and
inflammation.
07/18/09 7