Calzada-Sierra D J, Gómez-Fernández L, Mustelier-Bécquer R, Monreal-González R
Centro Internacional de Restauración Neurológica, CIREN, La Habana, Cuba.
Rev Neurol. 1999;29(9):814-7.
The tarsal tunnel syndrome is uncommon. It is a neuropathy of the tibial nerve at the level of the tarsal tunnel. The main symptom is pain of the sole of the foot. On percussion Tinel's sign may be found, with sensory loss all over the sole of the foot, or in parts of it, together with weakness of the intrinsic muscles of the foot. In all three cases nerve conduction studies were done and needle electromyography was also done in two cases, confirming the clinical diagnosis.
The three patients were treated conservatively (rest, vitamin B complex and antiinflammatory analgesics). Two patients improved but one required surgical treatment when medical treatment alone was found not to be satisfactory. At the present time, all three patients are asymptomatic.
The tarsal tunnel syndrome is uncommon but not unimportant. In most patients it presents as a syndrome of intense pain of the sole of the foot, with typical clinical features, usually unilateral. Nerve conduction studies and needle electromyography are particularly useful for confirmation of the diagnosis by localization of the problem. Initially conservative treatment is indicated in all cases. Those which do not respond to this will require surgical intervention.
跗管综合征并不常见。它是胫神经在跗管水平处的一种神经病变。主要症状是足底疼痛。叩诊时可引出Tinel征，伴有整个足底或部分足底感觉丧失，以及足部内在肌无力。在所有这三例病例中均进行了神经传导研究，其中两例还进行了针极肌电图检查，证实了临床诊断。
这三名患者均接受了保守治疗（休息、复合维生素B和抗炎镇痛药）。两名患者病情好转，但有一名患者在发现单纯药物治疗效果不佳时需要手术治疗。目前，这三名患者均无症状。
跗管综合征并不常见，但并非不重要。在大多数患者中，它表现为足底剧痛综合征，具有典型的临床特征，通常为单侧。神经传导研究和针极肌电图对于通过问题定位来确诊特别有用。所有病例最初均应采取保守治疗。那些对此无反应的病例将需要手术干预。
