28035 Release, tarsal tunnel (posterior tibial nerve decompression)

Name of the Procedure:

Release, Tarsal Tunnel (Posterior Tibial Nerve Decompression)

Summary

A tarsal tunnel release is a surgical procedure aimed at relieving pressure on the posterior tibial nerve, which runs through the tarsal tunnel in the ankle. By decompressing this nerve, the procedure alleviates pain, tingling, and numbness in the foot and ankle.

Purpose

This procedure addresses tarsal tunnel syndrome, a condition caused by compression of the posterior tibial nerve. The goals are to reduce chronic pain, restore sensation, and improve functionality and mobility of the foot.

Indications

• Persistent pain in the foot and ankle
• Numbness or tingling in the sole of the foot
• Weakness in the foot muscles
• Swelling around the ankle
• Symptoms that do not improve with conservative treatments such as medication, physical therapy, or orthotics

Preparation

• Fasting several hours before the procedure, as instructed by your physician
• Discontinuation or adjustment of certain medications, especially blood thinners
• Complete pre-operative assessments, including blood tests and imaging studies (e.g., MRI, ultrasound) to confirm the diagnosis

Procedure Description

1. The procedure typically begins with local anesthesia, although general anesthesia may be used.
2. An incision is made near the inner ankle to access the tarsal tunnel.
3. The surgeon carefully releases the ligament that forms the roof of the tarsal tunnel, relieving pressure on the posterior tibial nerve.
4. Any additional structures compressing the nerve, such as bone spurs or cysts, are removed.
5. The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure generally takes about 1 to 2 hours.

Setting

This surgery is performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon or podiatric surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses or assistants

Risks and Complications

• Infection
• Nerve damage
• Blood clots
• Recurrence of symptoms
• Prolonged swelling and pain

Benefits

• Relief from chronic pain and discomfort
• Improved sensation and mobility
• Enhanced quality of life Patients typically begin to notice improvement within a few weeks to a few months after surgery.

Recovery

• Keep the surgical area clean and dry
• Use crutches or wear a walking boot as instructed
• Elevate the foot to reduce swelling
• Attend follow-up appointments for wound inspection and stitch removal
• Physical therapy may be recommended to regain strength and flexibility Recovery time varies, but most patients can resume normal activities within 6 to 12 weeks.

Alternatives

• Conservative treatments like physical therapy, orthotic devices, anti-inflammatory medications
• Corticosteroid injections to reduce inflammation
• Non-surgical nerve decompression techniques These alternatives may be less effective if symptoms are severe or if conservative treatment has already failed.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-surgery, discomfort and swelling are common, but pain management strategies include prescribed pain medication and ice application. Most patients experience a progressive decrease in symptoms over the recovery period.