TTS tends to be more common in athletes or individuals who tend to do a lot of standing as these people commonly put an excessive amount of stress on the tarsal tunnel area. Above, the Muscle has been dissected out and the Deep Fascia. ![]() Above, the Abductor Hallucis Muscle, and its deep fascia are seen near the bottom of the incision. Tarsal tunnel syndrome is an entrapment of the posterior tibial nerve or its branches within the tarsal tunnel.1 This syndrome is most frequently unilateral as opposed to carpal tunnel syndrome in the upper extremity, which is typically bilateral.2 Keck and Lam first described the term tarsal tunnel syndrome in 1962.3,4. Above, Release of the retinaculum and small varicose veins can be seen. Tarsal tunnel syndrome (TTS) involves entrapment of the tibial nerve at the medial ankle beneath the flexor retinaculum and its branches, the medial and lateral plantar nerves, as they course through the porta pedis formed by the deep fascia of the abductor. Other culprits include varicose veins, as well. Intraop Pics of Tarsal Tunnel Release (Below) Incision Placement is Key to the Perfect Tarsal Tunnel Release. Certain items that could cause compression of the nerve include benign tumors or cysts, bone spurs, inflammation of the tendon sheath, nerve ganglions, or swelling from a broken or sprained ankle.
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