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The failed tarsal tunnel release
1Section of Foot and Ankle, Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL 35205, USA. Gouldjs@aol.com
Foot and Ankle Clinics
|May 24, 2011
Summary
Revision surgery for failed tarsal tunnel release addresses anatomical errors or inadequate techniques. Strategies include completing insufficient releases, using barrier materials for scarring, and employing nerve reconstruction or stimulation for intrinsic damage.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Foot and Ankle Surgery
Background:
- Tarsal tunnel release surgery can fail due to various factors.
- Common causes include poor understanding of anatomy and suboptimal surgical techniques.
- Identifying the specific cause of failure is crucial for successful revision.
Purpose of the Study:
- To outline the causes of failed tarsal tunnel release.
- To describe strategies for revision surgery based on the cause of failure.
- To provide guidance on managing complex cases of tarsal tunnel syndrome.
Main Methods:
- Review of potential causes for surgical failure in tarsal tunnel release.
- Description of revision techniques for insufficient release.
- Discussion of adjunctive treatments like barrier materials for external scarring.
- Exploration of reconstructive options for intrinsic nerve damage.
Main Results:
- Revision surgery success depends on accurately diagnosing the cause of initial failure.
- Insufficient release requires completion of the original surgical plan.
- External scarring necessitates neurolysis with protective barrier materials.
- Intrinsic nerve damage may benefit from nerve wrapping, reconstruction, conduits, or nerve stimulators.
Conclusions:
- Failed tarsal tunnel release can be effectively managed with tailored revision strategies.
- Addressing anatomical or technical shortcomings is key to successful outcomes.
- Advanced techniques can restore function and alleviate pain in complex cases.
