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Tarsal Tunnel Surgery for Treatment of Tarsal Ganglion

A Rewarding Operation with Devastating Potential Complications

Gedge D. Rosson, MD ^*, Robert J. Spinner, MD  and A. Lee Dellon, MD 

^* Dellon Institute for Peripheral Nerve Surgery, Baltimore, MD. Dr. Rosson is now with the Department of Plastic Surgery, Johns Hopkins University, Baltimore, MD.
Departments of Neurosurgery, Orthopedics, and Anatomy, Mayo Clinic, Rochester, MN.
Departments of Plastic Surgery and Neurosurgery, Johns Hopkins University, Baltimore, MD; Divisions of Plastic Surgery and Neurosurgery, Department of Surgery, and Department of Anatomy, University of Arizona, Tucson.

Corresponding author: A. Lee Dellon, MD, 3333 N Calvert St, Ste 370, Baltimore, MD 21218.

Abstract

Three patients who originally presented with a mass in the tarsal tunnel are described to develop an algorithm for management of the tarsal ganglion. All three patients had complications from ganglion excision, including complete division of the posterior tibial nerve, injury to the posterior tibial artery, and ganglion recurrence. The guiding principles relating to the presence of an extraneural versus an intraneural ganglion are developed. An example of a posterior tibial intraneural ganglion is presented. (J Am Podiatr Med Assoc 95(5): 459–463, 2005)