This surgery involves cutting the ligament and other tissues that bind down the posterior tibial nerve and its branches.  The nerve and its branches are explored for areas of entrapment.  Structures that bind down or compress the nerve or its branches are released or excised.

Goals

• Reduce or eliminate related symptoms (numbness, pain, or other abnormal nerve sensations) on the bottom of the heel, sole, or ball of the foot.

Possible Alternatives to Surgery

• Orthoses / Arch Supports
• Cast / Night Splint
• Medications – Oral or injected
• Physical therapy
• Compression stockings (if varicosities are present)

Potential complications / Risks

Incomplete or no resolution of symptoms; Prolonged recovery – pain and/or swelling; Recurrence of symptoms; Nerve injury or numbness; Weakness of muscles of the sole and/or hammertoes; Delayed healing or non-healing of skin or soft tissue; Circulation disturbance of skin, soft tissue, or bone;  Infection of soft tissue or bone; Unsightly or painful scar; Tendonitis; Hematoma or bleeding complication; Phlebitis; Mild to life-threatening reaction to medications and/or anesthesia.

Usual Post-Operative Care / Recovery

Wear a cast, use crutches, and place absolutely no weight on the foot for up to 3 weeks; use elevation, rest, and prescribed medications for pain and swelling control;  Keep cast dry; sutures are removed in approximately 2 weeks; utilize anti-swelling and anti-stiffness physical therapy for 1 to 6 months; wean off crutches in 3 to 6 weeks; return to loose shoes or sneakers in approximately 3 to 6 weeks; return to fashionable shoes in 1 to 4 months; return to sedentary activities and/or occupation in 1 to 6 weeks; return to demanding activities and/or occupation in 1 to 4 months; use of orthotics may be required long-term.