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[Tarsal tunnel syndorme. A report of 3 cases]
D J Calzada-Sierra1, L Gómez-Fernández, R Mustelier-Bécquer
1Centro Internacional de Restauración Neurológica, CIREN, La Habana, Cuba. danny@neuro.sld.cu
Introduction:
The tarsal tunnel syndrome is uncommon. It is a neuropathy of the tibial nerve at the level of the tarsal tunnel. The main symptom is pain of the sole of the foot. On percussion Tinel's sign may be found, with sensory loss all over the sole of the foot, or in parts of it, together with weakness of the intrinsic muscles of the foot. In all three cases nerve conduction studies were done and needle electromyography was also done in two cases, confirming the clinical diagnosis.
Clinical Cases:
The three patients were treated conservatively (rest, vitamin B complex and antiinflammatory analgesics). Two patients improved but one required surgical treatment when medical treatment alone was found not to be satisfactory. At the present time, all three patients are asymptomatic.
Conclusions:
The tarsal tunnel syndrome is uncommon but not unimportant. In most patients it presents as a syndrome of intense pain of the sole of the foot, with typical clinical features, usually unilateral. Nerve conduction studies and needle electromyography are particularly useful for confirmation of the diagnosis by localization of the problem. Initially conservative treatment is indicated in all cases. Those which do not respond to this will require surgical intervention.