Endoscopic Resection of the Tarsal Tunnel Ganglion

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Endoscopic Resection of the Tarsal Tunnel Ganglion Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S. Arthroscopy Techniques Volume 5, Issue 5, Pages e1173-e1177 (October 2016) DOI: 10.1016/j.eats.2016.07.004 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Endoscopic resection of a tarsal tunnel ganglion in the right foot. The patient is in the prone position. Posterior ankle endoscopy is performed with the posteromedial portal (PMP) and posterolateral portal (PLP). The PLP is located on the lateral side of the Achilles tendon (AT), just above the posterior calcaneal tubercle (PT). The PMP is located at the intersection point between the medial border of the Achilles tendon and the line joining the undersurface of the sustentaculum tali and first metatarsal. Arthroscopy Techniques 2016 5, e1173-e1177DOI: (10.1016/j.eats.2016.07.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Endoscopic resection of a tarsal tunnel ganglion in the right foot. The patient is in the prone position. The posterolateral portal is the viewing portal. The flexor hallucis longus tendon (FHL) is identified. Arthroscopy Techniques 2016 5, e1173-e1177DOI: (10.1016/j.eats.2016.07.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Endoscopic resection of a tarsal tunnel ganglion in the right foot. The patient is in the prone position. The posterolateral portal is the viewing portal. The fascia (Fm) at the medial side of the flexor hallucis longus tendon (FHL) is released by an arthroscopic shaver through the posteromedial portal. Arthroscopy Techniques 2016 5, e1173-e1177DOI: (10.1016/j.eats.2016.07.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Endoscopic resection of a tarsal tunnel ganglion in the right foot. The patient is in the prone position. The posterolateral portal is the viewing portal. The tibial nerve (TN) is exposed. (FHL, flexor hallucis longus tendon.) Arthroscopy Techniques 2016 5, e1173-e1177DOI: (10.1016/j.eats.2016.07.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 Endoscopic resection of a tarsal tunnel ganglion in the right foot. The patient is in the prone position. The posterolateral portal is the viewing portal. The fascia at the medial side of the flexor hallucis longus tendon (FHL) is released by an arthroscopic shaver and a curved hemostat through the posteromedial portal. The ganglion (G) is then exposed. (TN, tibial nerve.) Arthroscopy Techniques 2016 5, e1173-e1177DOI: (10.1016/j.eats.2016.07.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 Endoscopic resection of a tarsal tunnel ganglion in the right foot. The patient is in the prone position. The posteromedial portal is the viewing portal. The ganglion (G) is resected by an arthroscopic shaver through the posterolateral portal. The shaver works on the medial side of the flexor hallucis longus tendon (FHL). (TN, tibial nerve.) Arthroscopy Techniques 2016 5, e1173-e1177DOI: (10.1016/j.eats.2016.07.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 7 Endoscopic resection of a tarsal tunnel ganglion in the right foot. The patient is in the prone position. The posteromedial portal is the viewing portal. After resection of the ganglion, the flexor digitorum longus tendon (FDL) is exposed. (FHL, flexor hallucis longus tendon; TN, tibial nerve.) Arthroscopy Techniques 2016 5, e1173-e1177DOI: (10.1016/j.eats.2016.07.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 8 Endoscopic resection of a tarsal tunnel ganglion in the right foot. The patient is in the prone position. The posterolateral portal is the viewing portal. The tibial nerve (TN) is examined for any residual external compression. (FDL, flexor digitorum longus tendon; FHL, flexor hallucis longus tendon.) Arthroscopy Techniques 2016 5, e1173-e1177DOI: (10.1016/j.eats.2016.07.004) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions