The tarsal tunnel syndrome, also called posterior tibial neuralgia, is a condition where the tibial nerve becomes compressed as it travels through the narrow tarsal tunnel, located on the inside of the leg. This compression leads to symptoms such as pain, tingling, and numbness in the plantar (bottom) aspect of the foot, which may worsen with activity or prolonged standing. The condition is often caused by factors such as injury, inflammation, or structural abnormalities that put pressure on the nerve.
The tibial nerve has three main branches: calcaneal, medial plantar, and lateral plantar. Compression of the tibial nerve in the tarsal tunnel can be attributed to two primary structures: the flexor retinaculum and a septum that divides the medial and lateral plantar nerves, along with the overlying fascia of the abductor hallucis muscle. To alleviate this compression, a tarsal tunnel release procedure is performed to release these restrictive structures. In this case, the patient sustained a traumatic lower leg injury that necessitates open reduction and internal fixation. The patient experienced pain, numbness, and sensory changes in the distribution of the tibial nerve. Tinel’s sign and a positive scratch collapse test are used to confirm the diagnosis of tarsal tunnel syndrome.