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Zig-Zag Skin Incision for Treatment of Tarsal Tunnel Syndrome
1Department of Neurological Surgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
2Department of Plastic Surgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
3Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan
4Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
Background: Tarsal tunnel syndrome (TTS) is a common entrapment neuropathy of the posterior tibial nerve. Surgery can be performed less invasively under local anesthesia. We adopted zig-zag skin incision to prevent postoperative wound complications.
Methods: Between July 2022 and June 2023, we operated on 19 legs of 14 consecutive TTS patients (5 males, 11 females; average age 73.3 years). We made a 2- to 3-cm zig-zag skin incision on the tarsal tunnel. After posterior tibial nerve decompression by posterior tibial artery (PTA) transposition, the subcutaneous layer was tightly sutured with 4-0 PDS and the skin was closed with Dermabond Advanced. We investigated adverse events that developed during the first 30 postoperative days and recorded surgical outcomes at the final visit.
Results: In all patients the nerves were successfully decompressed with PTA transposition. There were no intraoperative complications. During the 30 postoperative days there were no adverse events, including wound complications, and patients' symptoms improved significantly.
Conclusion: Zig-zag skin incision was easy and convenient for surgical TTS treatment and may be useful for preventing postoperative wound complications.
J Nippon Med Sch 2024; 91: 357-361
Keywords
adverse events, decompression, skin incision, surgery, tarsal tunnel syndrome
Correspondence to
Kazutaka Shirokane, MD, PhD, Department of Neurological Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
kazutaka-shirokane@nms.ac.jp
Received, October 27, 2023
Accepted, February 9, 2024
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