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Posterior tibia nerve neuropathy as a results of ankle sprain injury
Author(s):
Reichert P. (Poland)
,
Reichert P. (Poland)
Affiliations:
Krolikowska Aleksandra
,
Krolikowska Aleksandra
Affiliations:
Szuba L.
,
Szuba L.
Affiliations:
Witkowski J.
,
Witkowski J.
Affiliations:
Czamara A.
Czamara A.
Affiliations:
ESSKA Academy. -Reichert P. May 9, 2018; 209205; P01-1972
Assoc. Prof. Pawel -Reichert
Assoc. Prof. Pawel -Reichert
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Abstract
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Objectives: Tarsal tunnel syndrome is an entrapment neuropathy of the posterior tibial nerve in the tarsal tunnel. One of the potential causes of tarsal tunnel syndrome can be defined as direct trauma The aim of the study was to evaluate retrospectively the prognostic factors affecting the final outcome of surgical treatment of traumatic tarsal tunnel syndrome.

Methods: The retrospective study comprised a group of 22 patients treated of tarsal tunnel syndrome in 2009-2015. Age of patients ranged from 25 to 51 years. In diagnostic process electromyography and electroneurography (ENG), Tinel's sign and anesthetic confirmation were used. The results were evaluated according to Visual Analogues Scale (VAS), modified American Orthopaedic Foot and Ankle Society score (AOFAS) and ENG. Follow-up was 12 months-36 months.

Results: 18 patients received very good or good, 3 satisfactory, 1 poor results in the subjective and objective patient's assessment. The outcomes decreased from 6.5 (SD 1.4) points to 1.25 (SD 0.93) points according to VAS scale, and modified AOFAS increased from 29.28 (SD 8.08) points to 61.28 (SD 5.60). Patients with diagnosed cause, short period of time between onset of disease till surgery, and positive Tinel's sign achieved the best results.
The best results were achieved in the group which had the surgery within 6 month from injury (VAS decreased from 5.32± 0.83 to 0.88±0.65 modified AOFAS increase from 36.75± 7.90 to 64.37±3.95. The results according to time between symptoms and surgery in groups for less than six months and more than 12 months showed both statistically differences in VAS (t = 0.03; p < 0.05) and modified AOFAS (t < 0.01; p < 0.05) score. We did not observe these results in comparison of groups less than 6 months to between 6-12 months from symptoms to surgery and groups between 6-12 months to more than 12 months from symptoms to surgery group. The ENG revealed an increase in nerve conduction.14 patients had positive Tinel's sign. In this group 10 patients had a good or very good postsurgical outcome. Statistical differences (t < 0.01; p < 0.05 in VAS and t = 0.03 p < 0.05 modified AOFAS score) were revealed when 2 groups with confirmed Tinel's test to with negative Tinel's test were compared.

Conclusions: Immediate diagnosis and short period between occurrences of symptoms in surgical treatment improves the outcomes. Tinel's sign may be used as a prognostic factor.

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