Document Detail

Soleal sling syndrome (proximal tibial nerve compression): results of surgical decompression.
MedLine Citation:
PMID:  21987046     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although distal tibial nerve compression is well recognized, proximal tibial nerve compression remains a rarely recognized clinical condition. This report defines the presentation, diagnosis, surgical decompression technique, and clinical outcome of neurolysis of the tibial nerve at this soleal sling compression site.
METHODS: Forty-nine patients with 69 proximal tibial nerves (20 bilateral) were stratified retrospectively into three groups: neuropathy (n = 10), failed tarsal tunnel syndrome (n = 25), and trauma (n = 14). Pain level, strength of the flexor hallucis longus muscle, neurosensory testing of the hallux, and subjective sensory improvement were evaluated. Each proximal tibial nerve compression was subjected to neurolysis with division of the soleal sling.
RESULTS: Results were stratified into poor, fair, good, and excellent based on the amount of pain relief and improvement in motor and sensory function. In all groups combined, there were 13 excellent (26.5 percent), 13 good (26.5 percent), 18 fair (36.7 percent), and five poor (10.2 percent) results. Results in the neuropathy group were excellent in two patients, good in three, fair in four, and poor in one (mean follow-up, 18.7 months). Results in the failed tarsal tunnel syndrome group were excellent in two, good in six, fair in 13, and poor in four patients (mean follow-up, 13.9 months). The trauma subgroup had the best outcomes: excellent in nine patients, good in four, fair in one, and poor in zero (mean follow-up, 13.4 months).
CONCLUSION: Regardless of cause, if a proximal tibial nerve compression beneath the soleal sling is identified, neurolysis may improve pain and sensory and motor function.
Eric H Williams; Gedge D Rosson; Robert R Hagan; Shahreyar S Hashemi; A Lee Dellon
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  129     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-30     Completed Date:  2012-03-19     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  454-62     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Decompression, Surgical* / methods
Middle Aged
Nerve Compression Syndromes / diagnosis,  surgery*
Retrospective Studies
Tibial Neuropathy*
Treatment Outcome
Young Adult

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