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Predictive factors of effective tibial nerve release in tarsal tunnel syndrome
Maurice Bouysset1, Delphine Denarié2, Jean-Yves Coillard3
1Department of Rheumatology, Hospices Civils de Lyon, University Hospital Lyon Sud, Pierre-Bénite, France; University of Lyon 1, Lyon, France; 100 avenue de Saxe, 69003 Lyon, France.
Background:
Factors that may affect surgical decompression results in tarsal tunnel syndrome are not known.
Methods:
A retrospective single-center study included patients who had undergone surgical tibial nerve release. The effectiveness of decompression was evaluated according to whether the patient would or would not be willing to undergo another surgical procedure in similar preoperative circumstances.
Results:
The patients stated for 43 feet (51%) that they would agree to a further procedure in similar circumstances. Six feet with space-occupying lesions on imaging had improved results, but neurolysis failed in 9 feet with bone-nerve contact. Neurolysis was significantly less effective when marked hindfoot valgus (p = 0.034), varus (p = 0.014), or fasciitis (p = 0.019) were present.
Conclusions:
If imaging reveals a compressive space-occupying lesion, surgery has a good prognosis. In feet with static hindfoot disorders or plantar fasciitis, conservative treatment must be optimized. Bone-nerve contact should systematically be sought.
