Open Capsular Repair with Dermal allograft and tarsal tunnel release in the treatment of Tarsal Tunnel Syndrome in a Young Collegiate Athlete: A Case Report

Tarsal tunnel syndrome is an entrapment neuropathy of the posterior tibial nerve beneath the flexor retinaculum that can be precipitated by either intrinsic or extrinsic factors. We report a unique case of a posterior medial ankle joint capsular defect with localized fluid extravasation between the flexor digitorum longus and flexor hallucis longus leading to symptoms consistent with tarsal tunnel syndrome in a collegiate tennis player. This patient is a 19-year-old female with no past medical history who presented with symptoms consistent with tarsal tunnel syndrome. After confirmation with magnetic resonance imaging, the patient underwent capsular reconstruction with dermal allograft in combination with a tarsal tunnel release. The patient had improvement in pain and recovery of paresthesia 3 months postoperatively. At the latest follow-up of 1 year postoperatively, the patient has not had a recurrence of symptoms and has returned to the same level of competitive play. Many different causes of tarsal tunnel syndrome are described in the literature, but to our knowledge, there is no current literature that describes a defect in the tibiotalar joint capsule as a cause of tarsal tunnel syndrome.