Following surgery, a large bulky cotton wrapping immobilizes the ankle joint without plaster. The dressing may be removed at the one-week point and sutures at about three weeks. Complications may include bleeding, infection, and unpredictable healing. The incision may open from swelling. There may be considerable pain and cramping. Regenerating nerve fibers may create shooting pains. Patients may have hot or cold sensations and may feel worse than before surgery. Crutches are usually recommended for the first two weeks, as well as elevation to minimize swelling. The nerve will grow at about one inch per month. One can expect to continue the healing process over the course of about one year. Many patients report good results. Some, however, experience no improvement or a worsening of symptoms. In the Pfeiffer article (Los Angeles, 1996), fewer than 50% of the patients reported improvement, and there was a 13% complication rate. Tarsal tunnel can greatly impact patients quality of life. Depending on the severity, the ability to walk distances people normally take for granted (such as grocery shopping) may become compromised. Proper pain management and counseling is often required. Results of surgery can be maximized if all four of the medial ankle tunnels are released and you walk with a walker the day after surgery. Success can be improved to 80%. Incidence
Though TTS is rare, its cause can be determined in 70% of reported cases.
Famous case
According to South Koreas National Intelligence Service, North Korean leader Kim Jong Un had surgery to correct TTS in his right ankle, the source of a pronounced limp. Kims disappearance from public for six weeks around the suspected surgery created worldwide speculation about the future of Kim and North Korea. Society
As stated earlier, musculoskeletal disorders can cost up to $15–$20 billion in direct costs or $45–$55 billion in indirect expenses. This is about $135 million a day. Tests that confirm or correct TTS require expensive treatment options like X-rays, CT-scans, MRI and surgery. The three former options for TTS detect and locate, while the latter is a form of treatment to decompress tibial nerve pressure. Since surgery is the most common form of TTS treatment, high financial burden is placed upon those diagnosed with the rare syndrome. See also
Carpal tunnel syndrome
Cuboid syndrome

References


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