136 - Anterior Tarsal Tunnel Syndrome

Abstract

Anterior tarsal tunnel syndrome is caused by compression of the deep peroneal nerve as it passes beneath the superficial fascia of the ankle. The most common cause of this compression is trauma to the dorsum of the foot. Severe, acute plantar flexion of the foot has been implicated in anterior tarsal tunnel syndrome, as has wearing tight shoes or squatting and bending forward, such as when planting flowers. The syndrome has also been associated with hypertrophy of the extensor hallucis brevis muscle in dancers. Anterior tarsal tunnel syndrome is much less common than posterior tarsal tunnel syndrome. This entrapment neuropathy manifests primarily as pain, numbness, and paresthesias in the dorsum of the foot that radiate into the first dorsal web space; these symptoms may also radiate proximal to the entrapment, into the anterior ankle. No motor involvement occurs unless the distal lateral division of the deep peroneal nerve is affected.