The flexor retinaculum of the ankle (laciniate ligament) spans from the medial malleolus to the calcaneus, creating the tarsal tunnel through which the tibial nerve and posterior tibial tendons pass.
Forms the roof of the tarsal tunnel, constrains the posterior tibial tendons (TP, FDL, FHL) and the tibial nerve and vessels within their individual compartments behind the medial malleolus.
Tarsal tunnel syndrome from flexor retinaculum compression of the tibial nerve produces plantar foot numbness and burning. Release of the flexor retinaculum (tarsal tunnel release) decompresses the nerve. Anomalous muscles (accessory FDL, tibialis accessorius) within the tunnel can contribute to compression.
Tibial nerve compression within the flexor retinaculum tunnel producing plantar foot numbness and intrinsic muscle weakness, managed by surgical tarsal tunnel release.
Tarsal tunnel decompression releasing the flexor retinaculum and excising anomalous muscles (accessory FDL or tibialis accessorius) compressing the tibial nerve.
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