The surgical treatment of tarsal tunnel syndrome

Tarsal tunnel syndrome is an entrapment neuropathy involving the posterior tibial nerve within the tarsal canal. Typical symptoms include burning pain and paraesthesia along the medial ankle and plantar aspect of the foot. Although potential causes of tarsal tunnel syndrome include trauma, varicosities, tenosynovitis, space-occupying lesions, and hindfoot deformity, in most cases the aetiology is idiopathic. Surgical release of the posterior tibial nerve and its terminal branches is indicated if symptoms persist despite non-operative treatment. In this article, we discuss the pre-operative evaluation of these patients and illustrate in detail our preferred technique for surgical release.