Gould John S
Division of Orthopaedic Surgery, Section of Foot and Ankle, University of Alabama at Birmingham (UAB), 1313 13th Street South, Birmingham, AL 35243, USA.
Foot Ankle Clin. 2014 Sep;19(3):451-67. doi: 10.1016/j.fcl.2014.06.015. Epub 2014 Jul 12.
Recurrence of tarsal tunnel syndrome after surgery may be due to inadequate release, lack of understanding or appreciation of the actual anatomy involved, variations in the anatomy of the nerve(s), failure to execute the release properly, bleeding with subsequent scarring, damage to the nerve and branches, persistent hypersensitivity of the nerves, and preexisting intrinsic damage to the nerve. Approaches include more thorough release, use of barrier materials to decrease adherence of the nerve to surrounding tissues to avoid traction neuritis, excisions of neuromas using conduits, and consideration of nerve stimulators and systemic medications to deal with persistent neural pain.
跗管综合征术后复发可能是由于松解不充分、对所涉及的实际解剖结构缺乏了解或认识、神经解剖结构的变异、未能正确进行松解、出血并随后形成瘢痕、神经及其分支受损、神经持续过敏以及神经存在先前的内在损伤。治疗方法包括更彻底的松解、使用屏障材料以减少神经与周围组织的粘连以避免牵引性神经炎、使用导管切除神经瘤，以及考虑使用神经刺激器和全身性药物来处理持续性神经疼痛。
