Osteochondromas, the most common benign bone tumor also characterized by a stalk or a flat protuberance emerging from the surface of the bone, however, rarely occur in tarsal bones. Among the rest, a bony structure protuberated within the tarsal tunnel including talocalcaneal coalition, talar or calcaneal fracture, nonunion, or os sustentaculum tali have been identified as one of the significant factors to tarsal tunnel syndrome due to its firm mass effect. Symptoms of burning, tingling, and pain along the foot plantar region can be triggered by either intrinsic or extrinsic factors that compress the posterior tibial nerve beneath the flexor retinaculum. Tarsal tunnel syndrome is an entrapment neuropathy of the posterior tibial nerve or one of its branches within the tarsal tunnel on the medial aspect of the ankle. ConclusionsĪs for tarsal tunnel syndrome secondary to the identifiable space occupying structure with a distinct neurologic symptom, we suggest complete surgical excision of the causative structure in an effort to effectively relieve symptoms and prevent recurrence. ![]() ![]() Physical examination and radiographic examination at 2-year follow up revealed that tarsal tunnel was completely decompressed without any evidence of complication or recurrence. After surgery, the pain was relieved immediately and hypoesthesia disappeared 3 months postoperatively. The excised mass was diagnosed to be osteochondroma on the histologic examination. Surgical decompression of the posterior tibial nerve was performed by complete excision of the bony mass connected to the sustentaculum tali. On the radiological examination, 2.5 × 1 cm sized bony protuberance was found below the sustentaculum tali. Hard mass-like lesion was palpated on the posteroinferior aspect of the medial malleolus. ![]() Case presentationĪ 15-year-old male presented with the main complaint of burning pain and paresthesia on the medial plantar aspect of the forefoot to the middle foot region. This is a rare case of tarsal tunnel syndrome secondary to osteochondroma of the sustentaculum tali successfully treated with open surgical excision. Osteochondroma, the most common benign bone tumor, seldom occur in foot or ankle. Tarsal tunnel syndrome is an entrapment neuropathy that can be provoked by either intrinsic or extrinsic factors that compresses the posterior tibial nerve beneath the flexor retinaculum.
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