ULTRASOUND-GUIDED ANKLE DECOMPRESSION SURGERY (UGADS) - A MINIMALLY INVASIVE APPROACH FOR THE PROXIMAL TARSAL TUNNEL SYNDROME: A CADAVERIC STUDY

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Aim. The aim of this study, is to provide a safe ultrasound-guided minimally invasive surgical approach, for the proximal tarsal tunnel (PTT) release concerning nerve entrapments. Material and Methods. The study was carried out on 10 fresh-frozen feet. All of them were examined by US at the medial ankle region. The surgical entry point was marked throughout the course of the lancinate ligament (flexor retinaculum). Once the previous steps had been carried out, the flexor retinaculum release technique was carried out with a 2 mm entry. Results and Discussion. As a result, an effective and safe release was obtained in all fresh-frozen feet. The ultrasound (US) has proven to be a useful tool in diagnosis and invasive and surgical treatment. The etiology of PTT syndrome (PTTS) is still unclear, but the studies show how scars and fibrosis are one of the causes. However, the open surgery that we perform in this pathology has as main complication these risk factors. Therefore, we propose this decompression surgery of the tarsal canal, which minimizes the adverse effects and complications of this surgery. Conclusions. The results of our anatomic study indicate that our novel US-guided minimally invasive surgical approach, for the release of the flexor retinaculum, might be an effective, safe, accurate and quick decompression technique treating patients with a PTTS.