[Tarsal tunnel syndrome. Diagnosis and differential diagnosis]

The tarsal tunnel syndrome represents an entrapment neuropathy of the tibial nerve behind the internal malleolus under the retinaculum of the flexor muscles of the foot. In more than 3 out of 4 cases, it is a late consequence of twisting or fracture of the ankle. Local pain is increased by walking. In addition to local pain on pressure behind the internal malleolus, at a later stage paresis of the small foot muscles becomes evident with impaired abduction of the toes, decreased sensation and abnormally dry, smooth skin over the sole of the foot. The impairment of tibial nerve function can also be shown electrophysiologically. Surgical treatment is recommended for advanced cases.