Tarsal Tunnel Syndrome Surgery

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.

Candidates for tarsal tunnel release surgery are  those of the individuals whose tibial nerve has been damaged due to various factors. These include structural issues such as flat feet or high arches, injuries like ankle sprains or fractures, and the presence of irregular growths such as ganglion cysts, bone spurs, or varicose veins. Systemic conditions like hypothyroidism, diabetes, and arthritis can contribute to nerve compression. TTS is often an overuse injury, with a significant number of cases linked to prior ankle sprains. Eligible candidates include individuals who experience chronic foot swelling, including those managing arthritis or diabetes.

Tarsal tunnel decompression procedure aims to alleviate pressure on the tibial nerve by widening the tunnel and minimizing nerve compression. The procedure requires two incisions: one along the posterior third of the medial aspect of the lower leg, following the path of the tibial nerve. This incision allows access to the flexor retinaculum and the surrounding tissues that may be compressing the nerve. The second incision is placed at an angle along the course of the lateral plantar branch of the tibial nerve.

Tarsal tunnel syndrome surgery is done under general anaesthesia and takes about 1 to 2 hours, depending on the complexity of the condition.

The recovery time after tarsal tunnel syndrome surgery varies but generally unfolds over weeks to months, depending on individual healing rate and adherence to postoperative care.

• During the first two weeks, patients should avoid placing full weight on the affected foot. Crutches or a walker may be used for mobility to minimize strain.
• By the third or fourth week, light walking is possible provided the surgeon approves.
• Full recovery, including returning to strenuous activities like exercise, can take six weeks to several months.
• Closely following your surgeon’s guidance is crucial to avoid complications and achieve the best possible recovery outcome.
• Exercises such as calf stretching and nerve gliding may help reduce symptoms of TTS while also strengthening the tibialis posterior muscle. Consult with your doctor or physical therapist to tailor a safe and effective exercise plan that aligns with every stage of recovery. Exercise for the treatment of TTS may include: balance exercises, heel to toe walking, single leg stances on various surfaces and heel toe raises.

• The ankle is wrapped in a long, soft bandage to protect the surgical area.
• Pain can be managed with pain relievers, such as Tylenol, Motrin, or ibuprofen.
• Partial weight bearing is encouraged right after surgery. After a week, once the bandage is removed, patients are able to resume walking once again.
• Running and more intense physical activities can be gradually reintroduced after six weeks.
• Most patients experience immediate relief from pain and numbness, however, those with more severe cases may require several months.
• At Prospero medical, we closely monitor our patients’ recovery, for 6 months up to 12 months after surgery, even after they’ve returned to their home countries. It’s essential that any issues are promptly communicated to our clinic, as we want to ensure the best possible outcome before seeking any outside intervention.

Turkey has become one of the most sought-after destinations for medical tourism, combining cutting-edge healthcare services with the unmatched warmth of Turkish culture. If you’re contemplating tarsal tunnel syndrome surgery, Turkey offers several advantages that make it an appealing choice for patients worldwide:

• Turkish surgeons are internationally trained, highly skilled and experienced in performing complex procedures with precision. They bring a blend of global techniques and local expertise to every procedure.
• Private hospitals in Turkey are equipped with the latest surgical tools and diagnostic technologies.
• Surgery in Turkey is considerably more affordable than in the U.S. or Europe, without compromising on quality.
• Turkish hospitality ensures that post-operative care is not only professional but also compassionate and tailored to each patient’s needs.
• Many clinics offer packages which include physiotherapy and access to peaceful recovery environments, from Istanbul’s bustling charm to the tranquillity of coastal regions.

When selecting the right clinic for your tarsal tunnel syndrome surgery, several key factors should be considered. Amid the overwhelming presence of commercial advertisements and social media tactics, choosing the right clinic for your operation can feel like an uphill task. What should you prioritize when shortlisting clinics? The criteria to look for should include:

• Truthful medical advice, free from any commercial influence.
• A clinic that build a rapport with patients to understand their concerns and manage their expectations.
• A clinic that prioritized the patient’s well-being and safety ensuring these are always at the forefront of care.

A realistic price estimation for the treatment should be based on a careful review of the following factors:

• The professional standing and reputation of the clinic.
• The specific nature and complexities of the surgical procedure involved.
• The surgeon’s credentials and the overall quality of the aftercare services provided.
• Well defined terms of conditions, with clinical liabilities clearly outlined in an impartial manner and in the correct legislative format.

The cost of cruciate ligament repair in Turkey can vary depending on the factors outlined above. Although price may be a significant factor in deciding to seek surgery abroad, focusing solely on cost, without evaluating whether the clinic meets essential criteria, could lead to irreversible complications and end up being more expensive in the long run. At Prospero medical, we are committed to a transparent pricing policy, where every single service component is clearly outlined, helping patients make informed decisions about their surgical treatment. Our goal is to offer the most realistic and accurate pricing, in line with the level of medical care, the expertise of our surgeons, and the exceptional after-care services provided at our clinics in Turkey. We combine years of industry experience with high-quality, professional medical services to ensure the best value for our patients.

1. What is the tarsal tunnel and why is it important?

The tarsal tunnel is a narrow space on the inside of the ankle where the tibial nerve passes. This nerve controls feeling in the bottom of the foot. When the tunnel becomes tight, the nerve gets compressed and causes symptoms.

2. What happens to the tibial nerve in Tarsal Tunnel Syndrome?

The tibial nerve becomes compressed by the flexor retinaculum or surrounding tissues. This pressure affects the nerve’s ability to send signals, leading to pain, tingling, or numbness in the foot.

3. What symptoms should make me suspect Tarsal Tunnel Syndrome?

The symptoms of Tarsal Tunnel Syndrome are burning or sharp in the sole, tingling or numbess in the toes, pain that worsens with walking or standing, weakness when moving the foot and a “shock-like” feeling when the nerve is tapped.

4. Can Tarsal Tunnel Syndrome after an injury?

Yes. Injuries such as ankle sprains, fractures or trauma can cause swelling or scar tissue that compresses the tibial nerve.

5. How is Tarsal Tunnel Syndrome confirmed by doctors?

Doctor use Tinel’s test, scratch collapse test, EMG to check nerve function and MRI to look for cyst, masses, or nerve damage.

6. When is surgery recommended for Tarsal Tunnel Syndrome?

Surgery is recommended when symptoms last for months, conservative treatments do not help, there is a mass or structural problem, nerve tests show compression and pain affects daily life or walking.

7. What does tarsal tunnel surgery aim to do?

The goal is to release the pressure on the tibial nerve by cutting the tight tissues around it and removing anything that compresses the nerve, such as cysts or scar tissue.

8. What should I expect right after surgery?

You should expect the ankle will be wrapped in a soft bandage, you may need crutches, pain medication will be provided and you will rest in a recovery area until fully awake.

9. When can I start walking again?

Partial weight-bearing is allowed immediately. Most patients can walk more comfortably after the first week, once the bandage is removed.

10. How long does full recovery take?

Recovery varies, but most patients return to normal activities in 6 weeks to several months. Severe cases may take longer.

11. Will I feel immediate relief after surgery?

Many patients feel relief right away because the nerve is no longer compressed. However, if the nerve was severely irritated, recovery may take several months.

12. What exercises help after surgery?

The exercises help are calf stretching, nerve gliding exercices, balance training, heel-to-toe walking and single-leg stance exercies. These exercises help improve nerve mobility and foot strength.

13. Can Tarsal Tunnel Syndrome be treated without surgery?

Yes. Non-surgical treatments include rest and activity modification, anti-inflammatory medications, orthotics for flat feet, physical therapy and steroid injections. Surgery is only considered when these methods fail.

14. Why is Turkey a popular destination for Tarsal Tunnel Syndrome?

Turkey offers experienced surgeons, modern hospitals, affordable prices, compassionate post-operative care, physiotherapy and recovery packages.

15. How is the cost of Tarsal Tunnel Syndrome surgery determined?

The price depends on clinic reputation, surgeon experience, complexity of the surgery, quality of aftercare and transparent terms and conditions.