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Tarsal tunnel syndrome caused by an uncommon ossicle of the talus
- Source :
- Medicine. 97:e11008
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Rationale Tarsal tunnel syndrome (TTS) is a compressive neuropathy of the posterior tibial nerve or one of its branches within the tarsal tunnel that is often caused by a variety of space-occupying lesions, such as ganglia, lipomas, varicosities, neural tumors, trauma, or systemic disease. The os sustentaculi is a small accessory bone, bridged to the posterior aspect of the sustentaculum tali by fibrocartilage. To the best of our knowledge, this is a rare case of successful treatment of TTS caused by the os sustantaculi. Patient concerns A 37-year-old male presented with insidious onset of right ankle and foot pain for 1 year. He also complained of a tingling sensation and paresthesia from the plantar and medial aspect of the forefoot to the middle foot area along the main distribution of the medial plantar nerve. The symptoms were mild at rest, but increased upon prolonged walking. He had an ankle sprain history during a football game 2 years previously and recurrent ankle sprains had occurred more frequently in this ankle since that trauma. Diagnoses Plain standing anteroposterior and lateral view radiographic findings of the right ankle reveled an accessory ossicle located posterosuperomedial to the sustentaculum tali. A computed tomography scan showed that the ossicle articulated between the talus and calcaneus. A magnetic resonance image revealed mild bone marrow edema in the ossicle and medial displacement of the tarsal structures. Interventions Surgery was performed under general anesthesia. The ossicle was delineated from its surrounding structures and was removed. Tension on the nerve was released. Outcomes The patient's pain and hypoesthesia were immediately relieved, and the tingling sensation disappeared 6 months after surgery. The patient had no complications or recurrence of symptoms at the 1-year follow-up.
- Subjects :
- 030222 orthopedics
business.industry
030229 sport sciences
General Medicine
Tarsal tunnel syndrome
Sustentaculum tali
Anatomy
Hypoesthesia
medicine.disease
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
Ossicle
Medial plantar nerve
Medicine
Tarsal tunnel
Calcaneus
Ankle
medicine.symptom
business
Subjects
Details
- ISSN :
- 00257974
- Volume :
- 97
- Database :
- OpenAIRE
- Journal :
- Medicine
- Accession number :
- edsair.doi...........94106c105452d2bfb1acd6353d4f9f00
- Full Text :
- https://doi.org/10.1097/md.0000000000011008