Takakura Y, Kumai T, Takaoka T, Tamai S
Nara Medical University, Kashihara, Japan.
J Bone Joint Surg Br. 1998 Jan;80(1):130-3. doi: 10.1302/0301-620x.80b1.8224.
We examined seven patients with tarsal tunnel syndrome in one foot caused by talocalcaneal coalition and a ganglion. We excised the coalition and the ganglion in six of them. All the patients had pain, sensory disturbance in the sole, and a positive Tinel's sign. Older patients with a long history showed atrophy and weakness of the plantar muscles. Talocalcaneal coalition can be diagnosed on a plain lateral radiograph and an anteroposterior radiograph externally rotated 20 degrees, and confirmed by CT. MRI is also useful for diagnosis. The coalitions were medial, and the ganglion had developed from the incomplete part of the coalition; it was multilocular in some patients. After resection, there was early pain relief but sensory disturbances and Tinel's sign persisted. The postoperative results were excellent in one patient, good in four and fair in one.
我们检查了7例因距跟联合和腱鞘囊肿导致单足跗管综合征的患者。我们对其中6例患者切除了联合和腱鞘囊肿。所有患者均有疼痛、足底感觉障碍及阳性Tinel征。病史较长的老年患者出现足底肌肉萎缩和无力。距跟联合可通过常规侧位X线片及外旋20°的前后位X线片诊断，并通过CT确诊。MRI对诊断也有帮助。联合位于内侧，腱鞘囊肿由联合的不完整部分发展而来；部分患者为多房性。切除术后，疼痛早期缓解，但感觉障碍和Tinel征持续存在。术后结果1例为优，4例为良，1例为可。
