Department of Hand and Foot Surgery, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, 130021, Jilin, China.
Department of Anesthesiology, The First Hospital of Jilin University, Changchun, 130021, Jilin, China.
Cell Tissue Bank. 2021 Mar;22(1):115-122. doi: 10.1007/s10561-020-09871-y. Epub 2020 Oct 27.
Tarsal tunnel syndrome (TTS) is an entrapment neuropathy of the posterior tibial nerve or its terminal branches compressed by its fibro-osseous tunnel beneath the flexor retinaculum on the medial side of the ankle. The current study was a retrospective study of 107 cases of patients with TTS, in which the onset characteristics were summarized, the factors that might affect the surgical treatment effects of TTS were discussed and analyzed. The syndrome diagnoses and treatment experiences of TTS were extracted and analyzed. In our cohort, TTS was more often found in middle-aged and older women. And the medial plantar nerve bundle was the most frequently affected nerve structure. The efficacy of surgical treatment were correlated to the causes of the disease, involved nerve bundles, methods of operation, and whether neurolysis of the epineurium was performed. Neurolysis of the epineurium is was recommended for patients with an enlarged tibial nerve due to impingement. The Singh method was recommended to release the tibial nerve and its branches. Patients with negative preoperative EMG results should carefully be cautious when considering their decision to undergo surgical treatment.
跗管综合征（TTS）是一种神经卡压综合征，胫后神经或其终末支在踝内侧屈肌支持带下方的纤维骨性管内受压。本研究回顾性分析了 107 例 TTS 患者，总结其发病特点，探讨分析可能影响 TTS 手术治疗效果的因素。提取并分析 TTS 的诊断和治疗经验。在我们的队列中，TTS 多见于中老年人女性。而内侧足底神经束是最常受累的神经结构。手术治疗的疗效与病因、受累神经束、手术方法以及是否行神经外膜松解有关。对于因撞击而导致胫神经增粗的患者，建议行神经外膜松解术。推荐辛格（Singh）法松解胫神经及其分支。对于术前 EMG 结果为阴性的患者，在考虑是否进行手术治疗时应谨慎。
