Chen W S
Department of Orthopedic Surgery, Chang-Gung Memorial Hosp., Niao-Sung Hsiang, Kaohsiung, Taïwan.
Rev Chir Orthop Reparatrice Appar Mot. 1992;78(4):251-4.
Two cases of tarsal tunnel syndrome caused by lipoma are reported. Both patients had ankle pain that radiated to the sole for years. On physical examination, localized swelling behind medial malleolus was found. Tinel's sign was provoked by gentle percussion on the posterior tibial nerve and its branches. Electrophysiological study showed fibrillation in foot intrinsic muscles or prolongation of motor and sensory latency of plantar nerves. Computed tomography of the tarsal tunnel demonstrated areas of low density indicating masses of high lipid content. Exploration of tarsal tunnel revealed compression of the medial plantar nerve by a lipoma. After excision of the lipoma, both patients had complete relief of ankle and foot pain. Computed tomography is helpful in delineating the nature and extent of lipoma within the tarsal tunnel.
报告了两例由脂肪瘤引起的跗管综合征病例。两名患者均有多年的踝关节疼痛并放射至足底。体格检查发现内踝后方有局部肿胀。轻叩胫后神经及其分支可引出Tinel征。电生理研究显示足部固有肌有纤颤或足底神经运动和感觉潜伏期延长。跗管计算机断层扫描显示低密度区域，提示脂质含量高的肿块。跗管探查发现内侧足底神经被脂肪瘤压迫。切除脂肪瘤后，两名患者的踝关节和足部疼痛均完全缓解。计算机断层扫描有助于明确跗管内脂肪瘤的性质和范围。
