Tarsal tunnel syndrome: Anatomical facts and clinical implications

Abstract

Introduction: Tarsal tunnel syndrome (TTS) associates with the posterior tibial nerve (PTN) entrapment at the medial side of the ankle. TTS is a major cause of heel pain. The diagnosis and treatments have several techniques. For accurate diagnosis and effective treatment, the surgeons need to have detailed anatomical knowledge of the arrangement of PTN. The aim of this present study is to describe anatomical aspects and TTS including its etiology, diagnosis, and treatments. Material and Methods: This literature review was done by searching the data from the following databases such as PubMed, Google Scholar, Springer, Elsevier (ScienceDirect), and book chapter. Results: This literature review showed anatomical variations of the PTN and its branches that used the malleolar-calcaneal axis for measurement of branching point. Moreover, these studies showed the origin and the number of branches. The diagnosis of TTS can be used numerous techniques such as neurophysiology, electromyography (EMG), ultrasound scanning (US), and magnetic resonance imaging. The treatment for TTS includes conservative approach, open surgery, and endoscopic procedures. Discussion and Conclusion: The anatomical knowledge of the neurovascular structures at the medial side of the ankle is not only considered for diagnostic purposes but also it ensures safe and effective operative procedures. This literature review will be beneficial for academics and clinicians.