Effect of Foot and Ankle Position on Tarsal Tunnel Compartment Pressure

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  • Elly Trepman
    Chief, Foot and Ankle Service, Department of Orthopaedic Surgery, New York University, Hospital for Joint Diseases, New York, New York.
  • Nancy J. Kadel
    Department of Orthopaedics, University of Washington, Seattle, Washington.
  • Kathleen Chisholm
    Bioskills Learning Center, New England Baptist Hospital Bone and Joint Institute, Boston, Massachusetts.
  • Lynn Razzano
    Bioskills Learning Center, New England Baptist Hospital Bone and Joint Institute, Boston, Massachusetts.

Description

<jats:p>Tarsal tunnel intracompartment pressures were determined in 10 fresh-frozen normal human adult cadaver specimens. With the foot and ankle held in mild plantarflexion and neutral eversion-inversion, mean tarsal tunnel pressure was minimal (2 ± 1 mmHg). However, when the foot and ankle were positioned in full eversion, mean tarsal tunnel pressure increased to 32 ± 5 mmHg ( P ≤ 0.005); in full inversion, mean pressure increased to 17 ± 5 mmHg ( P ≤ 0.05). There was no significant difference in mean tarsal tunnel pressure between the everted and inverted positions. These results support the hypothesis that increased pressure within the tarsal tunnel when the foot is moved into the everted or inverted position may aggravate posterior tibial nerve entrapment. These findings may also provide an explanation for clinically observed aggravation of symptoms in these positions, night pain, and improvement of symptoms with neutral immobilization in some patients with tarsal tunnel syndrome.</jats:p>

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