Department of Orthopaedics and Accident Surgery Unit I & Spinal Disorders Unit, Christian Medical College, Vellore, India.
Foot Ankle Surg. 2009;15(4):207-9. doi: 10.1016/j.fas.2008.12.001. Epub 2009 Feb 11.
This is a report of tarsal tunnel syndrome (TTS) due to a specific malunited calcaneal fracture fragment in a 46-year-old man. He was treated non-operatively for extra-articular calcaneal fracture. Four months later he presented with pain, tingling and hypoaesthesia over the medial aspect of the heel. He had a positive Tinel's sign and a positive dorsiflexion-eversion test. Radiography revealed malunited calcaneal fracture along medial wall producing bony prominence. The tarsal tunnel was surgically decompressed by excising the malunited fragments. The branches of the posterior tibial nerve were stretched over these fragments intra-operatively. There was symptomatic improvement with surgical excision of the fragment, however, the hypoesthesia did not resolve completely. Appropriate initial treatment will help to prevent this complication.
这是一例由特定的跟骨骨折块畸形愈合引起的跗管综合征（TTS）的报告。患者为 46 岁男性，曾接受过关节外跟骨骨折的非手术治疗。四个月后，他出现足跟内侧疼痛、麻木和感觉减退，Tinel 征阳性，背屈-外翻试验阳性。放射摄影显示跟骨内侧壁畸形愈合的骨折块，产生骨突。通过切除畸形愈合的骨折块对跗管进行了手术减压。术中发现后胫神经分支在这些骨折块上被拉伸。通过手术切除骨折块，症状得到了改善，但麻木感并未完全缓解。适当的初始治疗将有助于预防这种并发症。
