Tarsal tunnel syndrome results from compression of the tibial nerve, which runs through a narrow passageway in the ankle called the tarsal tunnel. This pressure can cause pain, numbness, and tingling along the bottom of the foot. When non-surgical treatments fail, a tarsal tunnel release surgery may be recommended to alleviate the pressure on the nerve. This guide offers a visual and descriptive overview of the surgical experience and recovery, from incision to the final scar.
The Surgical Procedure Visualized
The goal of tarsal tunnel release surgery is to create more space for the tibial nerve. This nerve travels through the tarsal tunnel, a space on the inside of the ankle formed by ankle bones and a thick ligament called the flexor retinaculum. During the procedure, the surgeon makes an incision along the inner ankle to access this ligament. Pre-operative markings are often drawn on the skin to map the path of the nerve and plan the incision.
Once the flexor retinaculum is exposed, the surgeon cuts it. This action releases the tension on the ligament, allowing it to spread apart and enlarge the tunnel so the tibial nerve can function without compression. The surgeon may also inspect the nerve’s branches and remove other sources of compression, like scar tissue or cysts, before closing the incision.
Before and Immediately After Surgery
Prior to surgery, the foot appears normal, with the symptoms being internal. Once the surgeon closes the incision, the ankle is wrapped in a large, soft, and sterile dressing. This initial bandage is meant to protect the wound and manage swelling.
When this first dressing is removed within a week or two, the incision site becomes visible. The incision will be closed with sutures, staples, or surgical glue and appears as a clean line along the inner curve of the ankle. The surrounding skin is often slightly swollen and may show some bruising.
The Healing and Recovery Process
Approximately one to two weeks after the operation, the incision may still be red and slightly raised. This is the period when sutures or staples are removed, and small scabs may form along the wound as it continues to heal.
Between four and six weeks post-surgery, the incision line will be fully closed and transition from red to a pinkish or brownish hue as initial swelling subsides. At this stage, the scar begins to mature. By the two-to-three-month mark, the scar becomes flatter, smoother, and lighter in color. Patients often transition from a protective boot to supportive footwear during this time.
Final Scar Appearance
The long-term appearance of a tarsal tunnel surgery scar becomes evident around six months to a year after the procedure. A well-healed scar presents as a fine, pale line that is flat against the skin. Its final look is influenced by factors including the surgical technique, an individual’s skin tone, and their body’s healing response.
Adherence to post-operative care instructions is also a factor in the final outcome. Protecting the new scar from sun exposure can prevent it from darkening, and some surgeons may recommend gentle scar massage after the wound has fully closed. This helps soften the tissue and ensure the scar tissue is flexible, contributing to a more favorable cosmetic result.