Endoscopic release of the tarsal tunnel : a suggested surgical approach

Tarsal Tunnel Syndrome is the term used to designate the compression of the posterior tibial nerve within the tunnel or of one of its terminal branches leaving the tunnel. This syndrome is due to a neurogenic cause and affects the area supplied by the tibial nerve. The tibial nerve has three branches: the medial plantar nerve, the medial lateral nerve, and the medial calcaneus nerve. The osteofibrous tunnel is posterior to the medial maleolus, tis floor being formed by the medial talar surface, the sustentaculum tali, and the medial wall of the calcaneus. It is covered by the flexor retinaculum that is posteriorly continuous to the superficial and deep aponeurosis of the leg. The base of the flexor retinaculum corresponds to the upper margin of the abductor hallucis muscle. The most often sites of compression are anatomically related to the pathway established by the surrounding inelastic elements (1,5,7).