Malunited calcaneal fracture fragments causing tarsal tunnel syndrome: a rare cause.
This is a report of tarsal tunnel syndrome (TTS) due to a specific malunited calcaneal fracture fragment in a 46-year-old man. He was treated non-operatively for extra-articular calcaneal fracture. Four months later he presented with pain, tingling and hypoaesthesia over the medial aspect of the heel. He had a positive Tinel's sign and a positive dorsiflexion-eversion test. Radiography revealed malunited calcaneal fracture along medial wall producing bony prominence. The tarsal tunnel was surgically decompressed by excising the malunited fragments. The branches of the posterior tibial nerve were stretched over these fragments intra-operatively. There was symptomatic improvement with surgical excision of the fragment, however, the hypoesthesia did not resolve completely. Appropriate initial treatment will help to prevent this complication.
Manasseh
Nithyananth
N
Department of Orthopaedics and Accident Surgery Unit I & Spinal Disorders Unit, Christian Medical College, Vellore, India. manasseh@cmcvellore.ac.in
Cherian
Vinoo Mathew
VM
Abel
Livingston
L
D002111:Calcaneus / Q000293:injuries*; D019299:Decompression, Surgical / Q000379:methods; D003937:Diagnosis, Differential; D004576:Electromyography; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017759:Fractures, Malunited / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D013641:Tarsal Tunnel Syndrome / Q000175:diagnosis / Q000209:etiology*