TARSAL TUNNEL-SYNDROME - A STUDY OF THE CLINICAL AND NEUROPHYSIOLOGICAL RESULTS OF DECOMPRESSION

The neurophysiological and clinical outcomes of surgical decompression of 22 cases of tarsal tunnel syndrome are analysed. Recent work by Pf eiffer & Cracchiolo(1) has suggested a successful outcome in only 44% of cases. We have reviewed the outcome of surgery both clinically and with the use of nerve conduction studies. Pre- and post-operative moto r conduction delays in the plantar nerves are compared with clinical r esults found both in the clinic and later by a postal questionnaire. D espite careful clinical and neurophysiological assessment prior to a f ull surgical release, only 42% of patients had a satisfactory outcome. A larger reduction in plantar nerve conduction delay post-operatively corresponded well to an improvement in symptoms. However, we were una ble to predict which cases would respond to decompression using clinic al or electrophysiological methods. We question the use of nerve condu ction studies in tile diagnosis of tarsal tunnel syndrome, and also th e role of surgery in the management of this condition.