Tarsal Tunnel Surgery Abroad: Lithuania
Price in GBP
Price in EUR
- Tarsal tunnel surgery – 1.600 £
- consultation with the surgeon
- necessary health tests
- surgery
- anaesthesia
- hospitalisation
- 24/7 personal assistance during your stay
- transfers to / from the airport, hotel and clinic
- all documents translated to English
Get your surgery for free by claiming a refund from your local health board. The clinic helps patients with the documents needed to claim a refund after following the EU directive route for medical treatment abroad. It applies to patients who are insured under the systems of one of the EU countries and may not get the surgery due to long waiting times.
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Nordorthopaedics Center Of Excellence
Refund for EU patients
Get your surgery for free by claiming a refund from your local health board. The clinic helps patients with the documents needed to claim a refund after following the EU directive route for medical treatment abroad. It applies to patients who are insured under the systems of one of the EU countries and may not get the surgery due to long waiting times.
Rehabilitation package
The rehabilitation centre is located at a SPA resort town called Druskininkai. It is equipped with modern facilities. The professionals there have years of experience working with people after various surgeries and injuries.
Rehabilitation in Lithuania – from € 130 / £ 116 per day
- personalized rehabilitation course
- room with TV and private bathroom
- three meals a day
- all medication needed
- transportation to/from the rehabilitation centre
An individual rehabilitation program is prepared for each patient depending on the type of surgery, general patient‘s well-being, health status and other factors.
Our rehabilitation centre
Our clinic
What sets us apart from other clinics?
Our clinic works with highly professional and educated surgeons. They have 10-20 years of experience in the field of orthopaedic surgery. They each perform 500 surgeries per year. Moreover, our surgeons are members of various prestigious surgical societies both Lithuanian and international. Our joint replacement surgeon S. Tarasevicius is an author of 150 scientific publications in different medical journals. Find more information about our surgeons here.
Our clinic works according to the highest standards set by the European Union. This helps to guarantee the quality of medical service.
During your entire stay in Lithuania you will receive personal care as well as transport to and from the clinic, hotel, and airport. You will not have to worry about a thing. You will be assisted from the moment of plane landing in Vilnius or Kaunas airport till your departure.
We have no waiting line so we can schedule your surgery as soon as you are ready to do so.
Everyone in our clinic speaks English, including nurses, assistants and the surgeon.
2-3 hour regular flights operate from all main airports in the UK & Ireland. Lithuania is closer than you thought. You can find the list of direct flights here. Please note that airlines constantly add new flights and new destinations, therefore feel free to contact us if you need help choosing the flight that suits you best.
Lithuania has been a part of the EU and NATO since 2004. Lithuania has one of the fastest growing economies in the whole region and the second fastest internet speed in the world. Lithuanian medical schools have trained many medical professionals who are highly appreciated and employed by many foreign hospitals, among which hospitals in the UK. Our clinic works according to the highest standards set to the medical institutions by the European Union.
COVID-19 situation: We're open! Accepting patients from USA and Canada
Our clinic is open and operates in accordance with all safety requirements. All the procedures are implemented as usual. You can read about the latest COVID-19 updates here.
Defining tarsal tunnel syndrome
Tarsal tunnel syndrome (TTS), also known as the posterior tibial neuralgia or entrapment neuropathy, defines pain and paraesthesias over the sole of the foot which are caused by entrapment or compression of the posterior tibial nerve or any of its branches. The cause of TTS can be identified in only 50% of cases and include fracture callus (the bony healing tissue around the ends of the broken bone), exostosis (outgrowth of the bone), lipoma, ganglion of the tendon, engorged venous plexus, valgus deformity (outward deviation of the foot).
Anatomy of tarsal tunnel
This syndrome was called the Tarsal tunnel syndrome because of the topographic anatomy of the posterior tibial nerve. This nerve threads the narrow tarsal tunnel which is a structure of a dense fibrous tissue. The medial wall of the tarsal tunnel is the tibia and the lateral wall is the flexor retinaculum. The flexor retinaculum is a fibrous band located in the medial part of the tarsus (behind the medial malleolus). It forms a canal (the tarsal tunnel) for the tendons, vessels and the posterior tibial nerve.
Symptoms of tarsal tunnel syndrome
TTS usually causes pain or paraesthesias (abnormal sensations) or numbness over the sole of the foot. Actually, the symptoms vary a lot.
- Most patients define the pain as burning or a dull ache.
- However, it can also manifest as crampy or spastic pain.
- Moreover, in some patients the pain radiates up to the medial calf.
- In addition, prolonged standing or walking aggravates the symptoms while rest usually relieves them.
- Furthermore, some patients report that the symptoms flare-up at night while sleeping in the bed.
Physical examination
In order to diagnose the Tarsal tunnel syndrome, some tests should be done after evaluating the symptoms.
The test called Tinel‘s sign is probably the most significant. In a test a doctor taps the medial side of the ankle. If the posterior tibial nerve is compressed or entrapped, the patient feels tingling sensation that radiates toward the toes.
The physical examination may also reveal reduced sensitivity to light touch or temperature.
The doctor may also ask the patient to turn the sole of the foot outward and point the toes upward in order to verify if these motions aggravate the symptoms (which is typical of TTS).
Other tests
Usually, the diagnosis of the TTS is based on the specific symptoms combined with the supportive physical findings.
In addition, in most cases the diagnosis is supported with electrodiagnostic tests. These are Electromyography test (EMG) or Nerve Conduction Velocity test (NCV).
Treatment of tarsal tunnel syndrome
The treatment of the TTS depends on the severity of the condition and the cause of it (if it is possible to identify it).
The nonsurgical treatment includes anti-inflammatory medications or steroid injections into the tarsal tunnel in order to reduce swelling and relieve pressure of the posterior tibial nerve. Moreover, antineuritic medications and occasionally tricyclic antidepresants may be used in order to improve the symptoms. Additionally, braces, walking boots and other orthopaedic devices may be recommended in order to limit the movements of the foot that could cause or aggravate the symptoms.
If the TTS is sever or resistant to the treatment (refractory TTS), the surgical release of the posterior tibial nerve is indicated. The operation is performed under the general anaesthesia. First, the surgeon makes a curved 8-10 cm length incision in the medial malleolus area.
Then, the flexor retinaculum is identified and separated from the underlying structures. The surgeon divides the flexor retinaculum and releases the posterior tibial nerve.
Complications
A recurrent compression of the nerve can occur relating to the postoperative scar tissue. Moreover, the branches of the posterior tibial nerve may be injured during the surgery. In some cases wound dehiscence and hematoma formation can occur.
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