Maurice Bouysset1, Delphine Denarié2, Jean-Yves Coillard3, Daniel Boublil4, Matthieu Lalevée5, Thierry Tavernier6, Olivier Fantino7, Tiphaine Lefebvre8, Joel Damiano9, Cyrille B Confavreux10, Jacques G Tebib11, Fabienne Coury12. 1. Department of Rheumatology, Hospices Civils de Lyon, University Hospital Lyon Sud, Pierre-Bénite, France; University of Lyon 1, Lyon, France; 100 avenue de Saxe, 69003 Lyon, France. Electronic address: maurice@bouysset.com. 2. Department of Rheumatology, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France. Electronic address: ddenarie@gmail.com. 3. Clinique du Parc, Lyon, France. Electronic address: jy.coillard@gmail.com. 4. Clinique du Parc, Lyon, France. Electronic address: d.boublil@cliniqueduparclyon.com. 5. Department of Orthopedic Surgery, University Hospital of Rouen, Rouen, France. Electronic address: matthieu.lalevee@gmail.com. 6. Department of Radiology, Clinique de la Sauvegarde, Lyon, France. Electronic address: thierry.tavernier@gmail.com. 7. Clinique du Parc, Lyon, France. Electronic address: o.fantino69@gmail.com. 8. 6 route de Sécheron, 73000 Jacob-Bellecombette, France. Electronic address: tiphaine.lefebvre2@gmail.com. 9. Department of Rheumatology, Saint-Camille Hospital, Bry-sur-Marne, France. Electronic address: joel.damiano@wanadoo.fr. 10. Department of Rheumatology, Hospices Civils de Lyon, University Hospital Lyon Sud, Pierre-Bénite, France; University of Lyon 1, Lyon, France. Electronic address: cyrille.confavreux@chu-lyon.fr. 11. Department of Rheumatology, Hospices Civils de Lyon, University Hospital Lyon Sud, Pierre-Bénite, France; University of Lyon 1, Lyon, France. Electronic address: tebib@aol.com. 12. Department of Rheumatology, Hospices Civils de Lyon, University Hospital Lyon Sud, Pierre-Bénite, France; University of Lyon 1, Lyon, France. Electronic address: fabienne.coury-lucas@chu-lyon.fr.
Abstract
BACKGROUND: Factors that may affect surgical decompression results in tarsal tunnel syndrome are not known. METHODS: A retrospective single-center study included patients who had undergone surgical tibial nerve release. The effectiveness of decompression was evaluated according to whether the patient would or would not be willing to undergo another surgical procedure in similar preoperative circumstances. RESULTS: The patients stated for 43 feet (51%) that they would agree to a further procedure in similar circumstances. Six feet with space-occupying lesions on imaging had improved results, but neurolysis failed in 9 feet with bone-nerve contact. Neurolysis was significantly less effective when marked hindfoot valgus (p = 0.034), varus (p = 0.014), or fasciitis (p = 0.019) were present. CONCLUSIONS: If imaging reveals a compressive space-occupying lesion, surgery has a good prognosis. In feet with static hindfoot disorders or plantar fasciitis, conservative treatment must be optimized. Bone-nerve contact should systematically be sought.
BACKGROUND: Factors that may affect surgical decompression results in tarsal tunnel syndrome are not known. METHODS: A retrospective single-center study included patients who had undergone surgical tibial nerve release. The effectiveness of decompression was evaluated according to whether the patient would or would not be willing to undergo another surgical procedure in similar preoperative circumstances. RESULTS: The patients stated for 43 feet (51%) that they would agree to a further procedure in similar circumstances. Six feet with space-occupying lesions on imaging had improved results, but neurolysis failed in 9 feet with bone-nerve contact. Neurolysis was significantly less effective when marked hindfoot valgus (p = 0.034), varus (p = 0.014), or fasciitis (p = 0.019) were present. CONCLUSIONS: If imaging reveals a compressive space-occupying lesion, surgery has a good prognosis. In feet with static hindfoot disorders or plantar fasciitis, conservative treatment must be optimized. Bone-nerve contact should systematically be sought.
Authors: Neeraj Vij; Heather N Kaley; Christopher L Robinson; Peter P Issa; Alan D Kaye; Omar Viswanath; Ivan Urits Journal: Orthop Rev (Pavia) Date: 2022-09-05