Tarsal Tunnel Syndrome Associated with an Accessory Muscle

2003 ◽  
Vol 24 (2) ◽  
pp. 132-136 ◽  
Author(s):  
Mitsuo Kinoshita ◽  
Ryuzo Okuda ◽  
Junichi Morikawa ◽  
Muneaki Abe
Keyword(s):  
Signs And Symptoms ◽  
Tarsal Tunnel ◽  
Tarsal Tunnel Syndrome ◽  
Accessory Muscle ◽  
History Of ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Electrophysiological Examination ◽  
Flexor Digitorum ◽  
Physical Findings

Between 1986 and 1999, we surgically treated 41 patients (49 feet) with Tarsal Tunnel Syndrome (TTS) in whom seven (eight feet) were associated with an accessory muscle. An accessory flexor digitorum longus muscle was present in six patients, and an accessory soleus muscle was in one patient (both feet). Three of them were males and four females, with the mean age of 33.1 years (12 to 59 years). The mean interval from the onset of symptoms to operation was 7.5 months (range, six to nine months). All patients with an accessory muscle had a history of trauma or strenuous sporting activity. The diagnosis of TTS was made based on physical findings in all the patients (eight feet) and confirmed in five patients (six feet) by electrophysiological examination. Imaging examinations (radiography, ultrasonography, MRI) revealed abnormal bone and soft tissue lesions in and around the tarsal tunnel. Preoperative signs and symptoms disappeared average 4.1 months after decompression of the tibial nerve in addition to excision of the muscle. No functional deficit was observed at final follow-up (24 to 88 months).

scholarly journals An Erratic Origin of Quadratus Plantae: An Embryological Error

2021 ◽  
Vol 9 (4) ◽  
pp. 8168-8172
Author(s):  
Sobana Mariappan ◽  
◽  
Geeta Anasuya. D ◽  
Sheela Grace Jeevamani MS ◽  
M. Vijaianand MD ◽  
...  
Keyword(s):  
Tarsal Tunnel ◽  
Main Function ◽  
Resonance Imaging ◽  
Tarsal Tunnel Syndrome ◽  
Flexor Digitorum Longus ◽  
Accessory Muscle ◽  
Male Cadaver ◽  
Flexor Digitorum Accessorius Longus ◽  
Tunnel Syndrome ◽  
Flexor Digitorum

Background: Quadratus plantae (Flexor digitorum accessorius) is one of the plantar muscles of foot . It is present in the second layer of sole. It takes origin from calcaneus and gets inserted into the tendon of flexor digitorum longus. The main function of it is to flex the lateral four toes in any position of the ankle joint by pulling on tendons of the flexor digitorum longus. Its variations like high origin have been implicated in the causation of tarsal tunnel syndrome. Methodology and Results: In routine dissection done on 22 cadavers, we observed a bilateral variant muscle flexor digitorum accessorius longus on both right and left sides in a male cadaver. The modality of choice in diagnosing the accessory muscle is magnetic resonance imaging. Conclusion: The knowledge of this variation would be essential to anatomists, radiologists and also to the foot surgeons while performing posterior ankle endoscopy. KEY WORDS: Flexor digitorum Accessorius longus, Tarsal tunnel syndrome, Posterior ankle endoscopy.

scholarly journals Comparison of tunnel ligament release instrument assisted minimally open surgery and conventional open surgery in the treatment of tarsal tunnel syndrome

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902097186
Author(s):  
Emre Gültaç ◽  
Barış Kılınç ◽  
Cem Yalın Kılınç ◽  
Mehmet Yücens ◽  
Nevres Hurriyet Aydogan ◽  
...  
Keyword(s):  
Open Surgery ◽  
Morbidity Rate ◽  
Tarsal Tunnel ◽  
Joint Movement ◽  
Tarsal Tunnel Syndrome ◽  
Limit Values ◽  
Muscle Testing ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Mini Open

Aim: This study compared the results of tarsal tunnel syndrome release surgeries using mini-open incisions and standard incisions. Patients and Methods: From January 2012 until April 2018, 31 feet of 29 patients diagnosed with tarsal tunnel syndrome were treated surgically. 15 feet of 15 patients underwent surgeries utilizing minimally open technique and 16 feet of 14 patients underwent surgeries utilizing standard incisions. The following preoperative and postoperative data was obtained: foot and ankle muscle testing results, posture analyses, anthropometric measurements, joint movement ranges, pain complaints, endurance evaluation results, and functional test results. The mean follow-up period was 38 months (13–88 months). Results: The mean operation times were 26.8 min (23–30 min) using the standard incision and 13.3 min (9–17 min) using the mini-open incision (p < 0.05). In the preoperative and postoperative comparisons of the total muscle strength and total joint limit values of the healthy and affected feet, statistically significant improvements were observed in both the mini-open incision and standard incision groups (p < 0.05). Moreover, statistically significant improvements were seen in both groups in the postoperative repeated toe raises for 1 minute assessments of the affected foot (p < 0.05). In the foot function index and functional foot score values, statistically significant improvements were seen between the preoperative and postoperative values in both groups (p < 0.05). Conclusions: Based on the results of this study, using a tunnel ligament release instrument assisted minimally open surgery to loosen the laciniate ligament may present an alternative to the standard incision, with its significantly decreased morbidity rate and cosmetic success.

scholarly journals The natural history of tarsal tunnel syndrome in diabetic subjects

2020 ◽  
Vol 73 (8) ◽  
pp. 1482-1489
Author(s):  
Willem D. Rinkel ◽  
Manuel Castro Cabezas ◽  
Erwin Birnie ◽  
J. Henk Coert
Keyword(s):  
Natural History ◽  
Tarsal Tunnel ◽  
Tarsal Tunnel Syndrome ◽  
History Of ◽  
Tunnel Syndrome

Anatomical Characteristics of the Flexor Digitorum Accessorius Longus Muscle and Their Relevance to Tarsal Tunnel Syndrome

2015 ◽  
Vol 105 (4) ◽  
pp. 344-355 ◽  
Author(s):  
Paul-André Deleu ◽  
Bernhard Devos Bevernage ◽  
Ivan Birch ◽  
Pierre Maldague ◽  
Vincent Gombault ◽  
...  
Keyword(s):  
Systematic Review ◽  
Differential Diagnosis ◽  
Cochrane Library ◽  
Flexor Hallucis Longus ◽  
Anatomical Location ◽  
Tarsal Tunnel ◽  
Tarsal Tunnel Syndrome ◽  
Flexor Digitorum Accessorius Longus ◽  
Tunnel Syndrome ◽  
Flexor Digitorum

Background Clinical and cadaver studies have reported that supernumerary muscles could be the etiology of a variety of pathologic disorders, such as posterior impingement syndrome, tarsal tunnel syndrome (TTS), and flexor hallucis longus tenosynovitis. We describe a unique variant of the flexor digitorum accessorius longus (FDAL) muscle as an apparent cause of TTS, functioning as an independent flexor of the second toe, which has not been described in the literature. In addition to this case report, a systematic review was performed of TTS caused by the FDAL muscle. Methods A targeted search of PubMed, the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, and Web of Science identified full-text papers that fulfilled the inclusion and exclusion criteria. Results Twenty-nine papers were identified for inclusion in the systematic review: 12 clinical papers of TTS caused by the FDAL muscle and 17 cadaver-based papers. Conclusions Clinicians often do not include the FDAL muscle in the differential diagnosis of TTS. This literature review suggests that the FDAL is an important muscle in terms of its functional and clinical significance. Knowledge of this muscle, its anatomical location and variations, and its magnetic resonance imaging characteristics may help clinicians make an accurate differential diagnosis.

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