Tarsal tunnel syndrome. Comprehensive review of 87 cases.

The results of the study indicate that tarsal tunnel syndrome is a pathologic condition in which there are multiple etiologies, which in some cases are poorly defined. In order to arrive at a definitive diagnosis, all available tests, including pathology reports, are important. Where proper diagnosis is made and followed with appropriate adjunctive care, the probability of recurrence will be minimized. Statistical information in itself is of some value, because it may help the podiatrist to more clearly diagnose and treat the patients in whom vague or general symptoms may exist.

Use of the subcutaneous tissue expander for delayed primary closure of flaps.

Two cases of deforming, painful scars on the dorsum of the foot are presented. Simple excision and primary closure of these wounds was not possible. Subcutaneous tissue expanders were implanted proximal to the scar and inflated gradually. Once adequate expansion was obtained, the expanders were removed, and scars excised. Closure was obtained by a pedicle and rotational advancement flap, without stress on the skin over the defect. A discussion of the indications, techniques, and pitfalls of tissue expansion is provided.

Volume injection adhesiotomy.

The authors present a modified method for treating painful cicatrix nerve entrapments. A series of three high-volume injections of local anesthetic, steroid, and hyaluronidase are used to perform percutaneous adhesiotomies and extraneural fibrosis decompression. If special attention is given to the tissue plane level in performing the sequential injections, circumferential neural trunk decompression or cicatrix adhesiotomy can be obtained. The procedure may decrease or eliminate pain sufficiently to circumvent surgical intervention.