Department of Neurological Surgery, Nippon Medical School Chiba Hokusoh Hospital.
Department of Plastic Surgery, Nippon Medical School Chiba Hokusoh Hospital.
J Nippon Med Sch. 2024;91(4):357-361. doi: 10.1272/jnms.JNMS.2024_91-404.
Tarsal tunnel syndrome (TTS) is a common entrapment neuropathy of the posterior tibial nerve. Surgery can be performed less invasively under local anesthesia. We adopted zig-zag skin incision to prevent postoperative wound complications.
Between July 2022 and June 2023, we operated on 19 legs of 14 consecutive TTS patients (5 males, 11 females; average age 73.3 years). We made a 2- to 3-cm zig-zag skin incision on the tarsal tunnel. After posterior tibial nerve decompression by posterior tibial artery (PTA) transposition, the subcutaneous layer was tightly sutured with 4-0 PDS and the skin was closed with Dermabond Advanced. We investigated adverse events that developed during the first 30 postoperative days and recorded surgical outcomes at the final visit.
In all patients the nerves were successfully decompressed with PTA transposition. There were no intraoperative complications. During the 30 postoperative days there were no adverse events, including wound complications, and patients' symptoms improved significantly.
Zig-zag skin incision was easy and convenient for surgical TTS treatment and may be useful for preventing postoperative wound complications.
跗管综合征（TTS）是一种常见的胫后神经卡压性周围神经病。手术可以在局部麻醉下进行，具有微创性。我们采用 Zigzag 皮瓣切口以预防术后伤口并发症。
2022 年 7 月至 2023 年 6 月，我们对 14 例连续 TTS 患者的 19 条腿（5 名男性，11 名女性；平均年龄 73.3 岁）进行了手术。我们在跗管处做 2-3cm 的 Zigzag 皮瓣切口。在通过将胫后动脉（PTA）转位进行胫后神经减压后，用 4-0 PDS 皮内缝合皮下层，并用 Dermabond Advanced 闭合皮肤。我们调查了术后 30 天内出现的不良事件，并在最后一次就诊时记录了手术结果。
所有患者的神经均通过 PTA 转位成功减压。术中无并发症。术后 30 天内无不良事件，包括伤口并发症，且患者症状明显改善。
Zigzag 皮瓣切口对于手术治疗 TTS 既简单又方便，可能有助于预防术后伤口并发症。
