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DR Z and Dr Ed - Is surgery always the protocal for TTS

Posted by Marty from SLC on 7/08/04 at 14:18 (154863)

DR Z and DR Ed,

Can one get better without surgery for TTS?

If one can get better without surgery what would be your coarse of action?

Re: DR Z and Dr Ed - Is surgery always the protocal for TTS

Ed Davis, DPM on 7/08/04 at 21:13 (154889)

Marty:
One thing we would like to know is if there is some growth or mass pressing on the nerve; if so, surgery is often the best course of action.
If not, we need to assume that the culprit is scar tissue. That can be treated with substances which break down scar tissue -- hyaluronidase (an enzyme) and a long acting steroid injected into the tarsal tunnel.
Ed

Re: DR Z and Dr Ed - Is surgery always the protocal for TTS

Dorothy on 7/08/04 at 22:31 (154895)

How are you able to discern whether a growth or mass is pressing on the nerve or whether it is scar tissue?

Re: it worth a shot.... no pun intended. LOL

Marty in SLC on 7/08/04 at 22:45 (154898)

The hyaluronidase can't dissolve the mass I guess. This really good to know doc, thanks.... I guess it's worth a shot, no pun intended. LOL to get the injection do to the fact that it just may be scare tissue.

Thanks,

Marty

Re: DR Z and Dr Ed - Is surgery always the protocal for TTS

Ed Davis, DPM on 7/09/04 at 14:32 (154964)

It depends on the type of mass. An MRI would detect about anything so it would probably be the diagnostic modality of choice but expensive. It would certainly be worth doing before surgery is contemplated.
Ed