A Review of Tenoscopic Management of Tarsal Sheath Injuries

The tarsal sheath encloses the tendon of insertion of the lateral digital flexor (LDFT) which comprises the combined deep and superficial heads of the deep digital flexor. It extends from the musculotendinous junction in the caudal crus to the junction of proximal and middle one-thirds of the plantar metatarsus. Proximally the sheath is voluminous as it is unrestrained by overlying structures. At the level of the tarsocrural joint the two structures are separated only by their synovial and thin fibrous walls. The tarsal flexor retinaculum covers the tarsal sheath from the level of the sustentaculum tali to the tarsometatarsal joint forming the tarsal canal. In the proximal metatarsus the overlying metatarsal fascia is thinner and the sheath again more voluminous ...