Extrinsic compression neuropathy of the tibial nerve secondary to accessory soleus muscle in a young teenager

Ismail Tawfeek Badr; Soliman Hassan; Dina Salem Fotoh; Mahmoud Mohamed Moawad

doi:10.1016/j.jcot.2019.12.008

Extrinsic compression neuropathy of the tibial nerve secondary to accessory soleus muscle in a young teenager

J Clin Orthop Trauma. 2020 Mar-Apr;11(2):302-306. doi: 10.1016/j.jcot.2019.12.008. Epub 2019 Dec 19.

Authors

Ismail Tawfeek Badr¹, Soliman Hassan¹, Dina Salem Fotoh², Mahmoud Mohamed Moawad³

Affiliations

¹ Orthopedic Department, Faculty of Medicine, Menoufia University, Egypt.
² Rheumatology,physical Medicine and Rehabilitation Department, Faculty of Medicine, Menoufia University, Egypt.
³ Radiology Department, Faculty of Medicine, Menoufia University, Egypt.

Abstract

Compression neuropathy of the tibial nerve or one of its terminal branches (tarsal tunnel syndrome) is relatively uncommon. Accessory musculature on the posteromedial aspect of the ankle is a rare extrinsic cause of compression. Therefore, it should be considered in patients with prolonged manifestations of tibial nerve compression. A detailed history and physical examination, together with proper radiological evaluation, allow for accurate diagnosis. In this case report, a 13-year old female teenager on history, physical examination, and imaging studies was diagnosed as compression neuropathy of the tibial nerve secondary to accessory soleus muscle. After surgical excision of the accessory soleus muscle with no tarsal tunnel release, the patient presented with complete resolution of her manifestations continued free of symptoms for one and half year postoperatively. The accessory soleus muscle is a potential extrinsic cause for tibial nerve compression neuropathy.

Level of clinical evidence: 5.

Keywords: Accessory soleus muscle; Compression neuropathy; Extrinsic; Tibial nerve; Uncommon.

Publication types

Case Reports