Pregledni rad
TARSAL TUNNEL SYNDROME IN ATHLETES
Tatjana Cicvara Pećina
; Zavod za radiologiju KB Dubrava,
Ivica Lucijanić
; Služba za ortopediju Opće bolnice Karlovac
Sanda Dubravčić- Šimunjak
; Zavod za fizikalnu medicinu, rehabilitciju i reumatologiju KB Sveti Duh
Sažetak
Tibial nerve compression syndrome or its affiliate's
branches n. plantaris medialis and lateralis in the fragment
of tarsal canal (tunnel) are known since 1962. as tarsal
tunnel syndrome. Tarsal channel is bone-connective
tissue tunnel located under medial part of the ankle, and
that channel is called the "hilum foot", because through
that tunnel all the anatomical structures from tendon to the
nerves and blood vessels are coming to the sole. The
tunnel is divided into two parts – on lacuna tendinum for
passage of m. tibialis posterior tendon, m. flexor hallucis
longus and m. flexor digitorum longus and on lacuna
vasonervorum for passage of the neurovascular bundle.
Lacuna vasonervorum is divided again into two parts –
into medial (upper tunnel) for the passage of n. plantaris
medialis and homonymous artery and veins and to lateral
(lower tunnel) for passage of n. plantaris lateralis, artery
and veins. Medial (upper) tunnel is in direct relation with
lacuna tendinum, which is one of the most common causes
of compression of n. plantaris medialis. Causes of tarsal
tunnel syndrome onset are found in possible space
engagement in the tunnel (by ganglion, anomalous muscle
or similar) or due to external pressure on the structures in
the tunnel. There are also idiopathic forms of the tarsal
tunnel syndrome, when you cannot detect a direct cause of
the characteristic symptoms in terms of firing, burning,
picking and reduced sensitivity especially in the first three
fingers of the feet. Besides the clinical diagnosis, new
opportunities of MRI and ultrasound diagnosis
procedures reduce the number of so-called idiopathic
forms of tarsal tunnel syndrome, and are useful for the
evaluation and for eventual failure of surgical treatment.
Tarsal tunnel syndrome is relatively rare described in
athletes and does occur more often in sports where
sprinting, jumping, or some specific movements (like in
judo) are present. The occurrence of symptoms is also
associated with biomechanical changes in the ankle and
foot. Idiopathic forms of tarsal tunnel syndrome, which
are more often found in athletes, may be explained by
frequent repetitive stretching (traction) of the nerve or by
tendinitis in the lacuna tendinum and can be classified as
overuse injuries. Although less frequently described than
in the general population, it is necessary to think of the
possibility of tarsal tunnel syndrome in athletes, and not
attribute present symptoms to the foot deformities or
varicose veins.
Ključne riječi
tarsal tunnel syndrome; clinical and radiological diagnosis; the causes of occurence in sport
Hrčak ID:
71349
URI
Datum izdavanja:
1.7.2011.
Posjeta: 11.463 *