Síndrome del túnel del tarso: análisis clínico-imagenológico de una serie de casos / Tarsal tunnel syndrome: Clinical-imaging analysis of a case series

Antecedentes: Revisión retrospectiva de pacientes con diagnóstico de síndrome del túnel del tarso (STT) tratados quirúrgicamente. Método: Serie retrospectiva de pacientes con diagnóstico de STT operados entre los años 2005 y 2020 en un mismo centro. Se analizan variables como edad, género, lado, nervio o rama afectada, clasificación, tipo de estudio imagenológico, resultado biopsia, tasa de infección, tasa recurrencia, secuelas, entre otras. Resultados: Se incluyen ocho hombres y dos mujeres con edad promedio de 47 años (rango 34-67) y seguimiento promedio de 62,2 meses (rango 2-149). Todos los casos se relacionan con una compresión intrínseca. La causa más frecuente fue la presencia de quiste (40%), seguida de adherencias perineurales (20%). El nervio tibial posterior fue el más afectado (50%) y 30% la rama plantar medial. La ecografía (70%) y resonancia magnética (50%) fueron los estudios más solicitados. No hubo casos de infección postoperatoria. Hubo tres pacientes que presentaron recurrencia de la lesión requiriendo una nueva cirugía. Conclusiones: El STT es una neuropatía que compromete al nervio tibial posterior o a algunas de sus ramas. En general su causa es la compresión del nervio por distintas estructuras como músculos accesorios, gangliones, entre otras. El diagnóstico es eminentemente clínico apoyándose en estudio por imágenes. El tratamiento quirúrgico presenta mejores resultados cuando la causa es una compresión intrínseca, aunque se describen tasas variables de recurrencia.(AU)

Background: Retrospective review of patients with a diagnosis of Tarsal Tunnel Syndrome (TTS) treated surgically. Methods: Retrospective series of patients with diagnosis of TTS operated between 2005 and 2020 in the same center. Variables such as age, sex, side, affected nerve or branch, classification, type of imaging study, biopsy result, infection rate, recurrence rate, sequelae, among others, were analyzed. Results: We included 8 men and 2 women with an average age of 47 years (range 34-67) and an average follow-up of 62.2 months (range 2-149). All cases were related to intrinsic compression. The most frequent cause was the presence of cyst (40%) followed by perineural adhesions (20%). The Posterior Tibial Nerve was the most affected (50%) and 30% the Medial Plantar Branch. Ultrasound (70%) and MRI (50%) were the most requested studies. There were no cases of postoperative infection. There were 3 patients who presented recurrence of the lesion requiring a new surgery. Conclusions: TTS is a neuropathy involving the posterior tibial nerve or some of its branches. In general, it is caused by compression of the nerve by different structures such as accessory muscles and ganglions, among others. The diagnosis is eminently clinical, supported by imaging studies. Surgical treatment presents better results when the cause is an intrinsic compression, although variable recurrence rates are described.(AU)

Tarsal tunnel syndrome: Clinical-imaging analysis of a case series / Síndrome del túnel del tarso: análisis clínico-imagenológico de una serie de casos

Background: Retrospective review of patients with a diagnosis of Tarsal Tunnel Syndrome (TTS) treated surgically. Methods: Retrospective series of patients with diagnosis of TTS operated between 2005 and 2020 in the same center. Variables such as age, sex, side, affected nerve or branch, classification, type of imaging study, biopsy result, infection rate, recurrence rate, sequelae, among others, were analyzed. Results We included 8 men and 2 women with an average age of 47 years (range 34-67) and an average follow-up of 62.2 months (range 2-149). All cases were related to intrinsic compression. The most frequent cause was the presence of cyst (40%) followed by perineural adhesions (20%). The Posterior Tibial Nerve was the most affected (50%) and 30% the Medial Plantar Branch. Ultrasound (70%) and MRI (50%) were the most requested studies. There were no cases of postoperative infection. There were 3 patients who presented recurrence of the lesion requiring a new surgery. Conclusions: TTS is a neuropathy involving the posterior tibial nerve or some of its branches. In general, it is caused by compression of the nerve by different structures such as accessory muscles and ganglions, among others. The diagnosis is eminently clinical, supported by imaging studies. Surgical treatment presents better results when the cause is an intrinsic compression, although variable recurrence rates are described.(AU)

Antecedentes: Revisión retrospectiva de pacientes con diagnóstico de síndrome del túnel del tarso (STT) tratados quirúrgicamente. Método: Serie retrospectiva de pacientes con diagnóstico de STT operados entre los años 2005 y 2020 en un mismo centro. Se analizan variables como edad, género, lado, nervio o rama afectada, clasificación, tipo de estudio imagenológico, resultado biopsia, tasa de infección, tasa recurrencia, secuelas, entre otras. Resultados: Se incluyen ocho hombres y dos mujeres con edad promedio de 47 años (rango 34-67) y seguimiento promedio de 62,2 meses (rango 2-149). Todos los casos se relacionan con una compresión intrínseca. La causa más frecuente fue la presencia de quiste (40%), seguida de adherencias perineurales (20%). El nervio tibial posterior fue el más afectado (50%) y 30% la rama plantar medial. La ecografía (70%) y resonancia magnética (50%) fueron los estudios más solicitados. No hubo casos de infección postoperatoria. Hubo tres pacientes que presentaron recurrencia de la lesión requiriendo una nueva cirugía. Conclusiones: El STT es una neuropatía que compromete al nervio tibial posterior o a algunas de sus ramas. En general su causa es la compresión del nervio por distintas estructuras como músculos accesorios, gangliones, entre otras. El diagnóstico es eminentemente clínico apoyándose en estudio por imágenes. El tratamiento quirúrgico presenta mejores resultados cuando la causa es una compresión intrínseca, aunque se describen tasas variables de recurrencia.(AU)

Tarsal tunnel syndrome: Clinical-imaging analysis of a case series. / Síndrome del túnel del tarso: análisis clínico-imagenológico de una serie de casos.

BACKGROUND: Retrospective review of patients with a diagnosis of Tarsal Tunnel Syndrome (TTS) treated surgically. METHODS: Retrospective series of patients with diagnosis of TTS operated between 2005 and 2020 in the same center. Variables such as age, sex, side, affected nerve or branch, classification, type of imaging study, biopsy result, infection rate, recurrence rate, sequelae, among others, were analyzed. RESULTS: We included 8 men and 2 women with an average age of 47 years (range 34-67) and an average follow-up of 62.2 months (range 2-149). All cases were related to intrinsic compression. The most frequent cause was the presence of cyst (40%) followed by perineural adhesions (20%). The Posterior Tibial Nerve was the most affected (50%) and 30% the Medial Plantar Branch. Ultrasound (70%) and MRI (50%) were the most requested studies. There were no cases of postoperative infection. There were 3 patients who presented recurrence of the lesion requiring a new surgery. CONCLUSIONS: TTS is a neuropathy involving the posterior tibial nerve or some of its branches. In general, it is caused by compression of the nerve by different structures such as accessory muscles and ganglions, among others. The diagnosis is eminently clinical, supported by imaging studies. Surgical treatment presents better results when the cause is an intrinsic compression, although variable recurrence rates are described.