Anterior Tarsal Tunnel Syndrome 355.8

synonyms:

Anterior Tarsal Tunnel Syndrome  ICD-9

• 355.5 Mononeuritis of lower limb; tarsal tunnel syndrome
• 355.8 Mononeuritis of lower limb;unspecified
• 956.3 Injury to peripheral nerve; peroneal nerve

Anterior Tarsal Tunnel Syndrome  Etiology / Epidemiology / Natural History

Anterior Tarsal Tunnel Syndrome  Anatomy

• Deep peroneal nerve (DPN)
• DPN impingement by distal inferior extensor retinaculum
• pts usually have dorsal osteophytes / ganglion over apex of medial longitudinal arch

Anterior Tarsal Tunnel Syndrome  Clinical Evaluation

• dysesthesias and paresthesias on dorsul of foot radiating into first web space
• Tinel’s sign over DPN
• decreased sensation in 1st dorsal web space
• palpate DPN, compare sides

Anterior Tarsal Tunnel Syndrome Xray / Diagnositc Tests

Anterior Tarsal Tunnel Syndrome  Classification / Treatment

• well-padded tonge shoe, loosely laced
• full-length rocker-sole steel shank @ 1/16” wide
• Surgery=locate DPN distally just lateral to EHB tendon, trace proximally releasing all fascial restraints.  Remove osteophyties or ganglion.  Surgery contraindicated if RSD present.

Anterior Tarsal Tunnel Syndrome  Associated Injuries / Differential Diagnosis

Anterior Tarsal Tunnel Syndrome Complications

• Continued parasthesias
• Dysesthesias
• Infection
• CRPS
• DVT / PE

Anterior Tarsal Tunnel Syndrome  Anterior Tarsal Tunnel Syndrome Follow-up Care

Anterior Tarsal Tunnel Syndrome  Review References