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Sinus tarsi denervation: clinical results.
A Lee Dellon1, Stephen L Barrett
1Institute for Peripheral Nerve Surgery, Baltimore, MD, USA.
Journal of the American Podiatric Medical Association
|March 22, 2005
Summary
Surgical resection of nerves causing sinus tarsi pain offers relief for recalcitrant lateral ankle pain. This denervation procedure successfully treated 77% of patients, restoring normal activities and footwear.
Area of Science:
- Orthopedic Surgery
- Neurology
- Pain Management
Background:
- Recalcitrant lateral ankle pain can originate from traumatic neuromas of the deep peroneal nerve branches supplying the sinus tarsi.
- Nerve blocks can confirm the deep peroneal nerve as the pain source.
- Surgical resection of these nerve branches is a potential treatment.
Purpose of the Study:
- To document the clinical outcomes of surgical resection of the deep peroneal nerve branches for sinus tarsi syndrome.
- To evaluate the efficacy of sinus tarsi denervation in alleviating chronic lateral ankle pain.
Main Methods:
- A cohort of 13 patients with sinus tarsi syndrome underwent surgical resection of the affected deep peroneal nerve branches.
- Clinical results were assessed at a minimum of 6 months postoperatively.
Main Results:
- 10 out of 13 patients (77%) reported complete pain relief, enabling them to wear normal shoes and return to work.
- Two patients (15%) experienced minor residual pain but resumed usual activities and footwear.
- One patient achieved some pain reduction but could not return to their usual activities.
Conclusions:
- Denervation of the sinus tarsi effectively relieves recalcitrant pain associated with the condition.
- This surgical approach may offer an alternative to subtalar fusion or arthroereisis, potentially avoiding their complications.
- Sinus tarsi denervation could allow continued use of arthroereisis implants in select cases with persistent pain despite objective findings.