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Pain at the Site of Tarsal Tunnel Incision Due to Neuroma of the Posterior Branch of the Saphenous Nerve

Jaesuk Kim Assistant Professor, Orthopedic Surgery, Division of Orthopedic Surgery, Kon-Kuk University School of Medicine, Seoul, Korea.

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A. Lee Dellon Professor of Plastic Surgery and Neurosurgery, Division of Plastic Surgery and Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD. Mailing address: 3333 N Calvert St, Ste 370, Baltimore, MD 21218.

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The authors conducted a retrospective review of 16 patients who presented with the complaint of pain at the incision site after tarsal tunnel decompression. Specifically, the pain was located at the proximal aspect of the tarsal tunnel decompression scar. The mean duration of pain was 21 months (range, 6 to 34 months). The pain was eliminated by a block of the distal saphenous nerve, demonstrating that the pain was due to a neuroma of this nerve. The pain was treated by resection of the distal saphenous nerve in the distal leg and implantation of the proximal end of this nerve into the soleus muscle. At a mean of 18.5 months after surgery (range, 6 to 33 months), excellent relief of pain was achieved in 76% of cases and good relief of pain in 24% of cases. (J Am Podiatr Med Assoc 91(3): 109-113, 2001)