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Introducción: no es la primera vez que la humanidad enfrenta las consecuencias catastróficas de una pandemia, hace un siglo fue la de la gripe española. La causada por COVID-19 en un mundo globalizado y conectado logró su rápida propagación, un alto impacto en el número de fallecidos y en la economía, y secuelas importantes sobre la salud mental. Objetivo: caracterizar las principales manifestaciones psiquiátricas en adultos evaluados por el servicio de psiquiatría de un hospital universitario de Bogotá, durante el confinamiento obligatorio por la pandemia de COVID-19 (20-03 a 01-06/2020). Materiales y métodos: estudio observacional retrospectivo de corte transversal que analizó las manifestaciones psiquiátricas más frecuentes en 122 pacientes. Resultados y discusión: hubo una notable reducción (47,7%) de las interconsultas, comparadas con el periodo prepandemia. El promedio de edad fue 51,7 ± 22 años, la mayoría fueron hombres (60,7%), 42,6% estaban desempleados y 92,6% eran contribuyentes del régimen de aseguramiento. Los hallazgos más frecuentes fueron ansiedad (35,2%), trastornos depresivos (32%) y delirium 23,7%; el intento suicida (12,3%) fue mayor que en un estudio previo en el servicio de urgencias. Ninguno de los pacientes presentó infección por COVID-19. Conclusiones: el confinamiento por la pandemia de COVID-19 disminuyó la demanda del servicio de psiquiatría, los trastornos de ansiedad, depresión y el intento suicida fueron los más frecuentes, siguiendo las tendencias esperadas. Es necesario desarrollar servicios de telepsiquiatría para afrontar emergencias futuras.

Morton's neuroma is a common painful pathology that occurs in the plantar forefoot. Many treatment options exist and surgical management is used after conservative treatment options fail. While within the literature, there is a high success rate with primary neurectomy procedures, the risk of recurrence of symptoms or "stump neuromas" remains difficult to treat and can lead to debilitating pain. This article expands on a previously published article to discuss an update on a nerve sparing, microneurosurgical, procedure for the management of Morton's neuromas.

To date, more than 150 surgical techniques have been described for the treatment of intractable nerve pain. However, owing to their technical complexity, as well as the lack of comparative studies in the literature, there is currently no consensus on the appropriate management of this often debilitating condition. Therefore, we present our surgical algorithm, based on Seddon's classification to differentiate the degree of nerve injury, and subsequent treatment course for the management of lower extremity neurogenic pain.

RNA binding proteins associated with amyotrophic lateral sclerosis (ALS) and muscle myopathy possess sequence elements that are low in complexity, or bear resemblance to yeast prion domains. These sequence elements appear to mediate phase separation into liquid-like membraneless organelles. Using fusion proteins of matrin 3 (MATR3) to yellow fluorescent protein (YFP), we recently observed that deletion of the second RNA recognition motif (RRM2) caused the protein to phase separate and form intranuclear liquid-like droplets. Here, we use fusion constructs of MATR3, TARDBP43 (TDP43) and FUS with YFP or mCherry to examine phase separation and protein colocalization in mouse C2C12 myoblast cells. We observed that the N-terminal 397 amino acids of MATR3 (tagged with a nuclear localization signal and expressed as a fusion protein with YFP) formed droplet-like structures within nuclei. Introduction of the myopathic S85C mutation into NLS-N397 MATR3:YFP, but not ALS mutations F115C or P154S, inhibited droplet formation. Further, we analyzed interactions between variants of MATR3 lacking RRM2 (ΔRRM2) and variants of TDP43 with disabling mutations in its RRM1 domain (deletion or mutation). We observed that MATR3:YFP ΔRRM2 formed droplets that appeared to recruit the TDP43 RRM1 mutants. Further, coexpression of the NLS-397 MATR3:YFP construct with a construct that encodes the prion-like domain of TDBP43 produced intranuclear droplet-like structures containing both proteins. Collectively, our studies show that N-terminal sequences in MATR3 can mediate phase separation into intranuclear droplet-like structures that can recruit TDP43 under conditions of low RNA binding.

The purpose of this study was to demonstrate use of a distally based peroneus brevis muscle flap in high-risk patients with diabetes and peripheral vascular disease for limb salvage of nonhealing heel ulcerations. Seventeen patients were referred for a below-knee amputation because of nonhealing heel ulcerations and peripheral vascular disease. As a last resort, 17 distally based peroneus brevis muscle flaps were elevated in 17 patients with full-thickness heel ulcerations measuring an average defect size of 14.11 cm2. All flaps were supplemented with concentrated bone marrow aspirate, negative pressure wound therapy, bilayer wound matrix, and static external fixation for an average time of 10.3 weeks. Split-thickness skin graft was delayed by an average of 17.5 days. All procedures were performed on patients diagnosed with diabetes, advanced peripheral arterial disease and a nonhealing heel ulcer present >1 year. All flaps survived at 1.5 years follow-up. The average time to healing was 10.3 weeks. No major amputations were performed to date. Partial tip necrosis occurred in 2 patients and healed uneventfully with local wound care. Distally based peroneus brevis muscle flaps in patients with diabetes and peripheral vascular disease offer a reliable alternative to limb salvage for full-thickness heel ulcerations measuring up to 7 × 6 cm. Combinatorial procedures are necessary to improve outcomes in high-risk patients whose alternative is a major amputation.

La salud mental percibida como el estado dinámico de bienestar emocional, que nos hace sentirnos en control de las situaciones que afrontamos en la siempre incierta tarea de gestionar la vida; que nos permite utilizar los recursos emocionales, cognitivos y mentales necesarios para trabajar, para establecer relaciones significativas, disfrutar la vida y para contribuir a la comunidad, es un componente esencial del bienestar y la salud general. La incertidumbre genera situaciones de gran tensión emocional que suplantan a la ansiedad del estado normal de alerta frente a lo novedoso, por una ansiedad patológica que fragmenta la continuidad del yo y perturba la toma de decisiones, según las circunstancias y el pasado del que decide. Esto nos coloca en el riesgo de pasar de los síntomas reactivos al estrés agudo (problemas) a las alteraciones persistentes de las funciones mentales (trastornos) como la depresión.

The management of pedal ulcerations is often challenging because of a failure to correct underlying biomechanical deformities. Without correcting the biomechanical driving force creating the increased plantar pressures, it is unlikely for routine wound care to provide lasting solutions to pedal ulcerations. Patients with diabetes often experience glycosylation of their tendons, leading to contracture and pursuant deformity, creating imbalanced pressure distributions and eventual plantar ulceration. This article evaluates the efficacy of various lower extremity tendon transfers to balance the foot and redistribute plantar pressures to prevent or heal ulceration.

Croft et al. demonstrate the use of recombinant adeno-associated viruses and organotypic brain slice cultures to study the central nervous system. This strategy can be used to model Alzheimer’s and Parkinson’s disease inclusion pathologies and determine mechanisms underlying neurodegeneration and therapeutic targets., It has been challenging to produce ex vivo models of the inclusion pathologies that are hallmark pathologies of many neurodegenerative diseases. Using three-dimensional mouse brain slice cultures (BSCs), we have developed a paradigm that rapidly and robustly recapitulates mature neurofibrillary inclusion and Lewy body formation found in Alzheimer’s and Parkinson’s disease, respectively. This was achieved by transducing the BSCs with recombinant adeno-associated viruses (rAAVs) that express α-synuclein or variants of tau. Notably, the tauopathy BSC model enables screening of small molecule therapeutics and tracking of neurodegeneration. More generally, the rAAV BSC “toolkit” enables efficient transduction and transgene expression from neurons, microglia, astrocytes, and oligodendrocytes, alone or in combination, with transgene expression lasting for many months. These rAAV-based BSC models provide a cost-effective and facile alternative to in vivo studies, and in the future can become a widely adopted methodology to explore physiological and pathological mechanisms related to brain function and dysfunction.

While HER2 and EGFR are overexpressed in breast cancers and multiple other types of tumors, the use of EGFR and/or HER2 inhibitors have failed to cure many cancer patients, largely because cancers acquire resistance to HER2/EGFR-specific drugs. Cancers that overexpress the HER-family proteins EGFR, HER2, and HER3 are uniquely sensitive to agents that disrupt HER2 and EGFR protein folding. We previously showed that disruption of disulfide bond formation by Disulfide Disrupting Agents (DDAs) kills HER2/EGFR overexpressing cells through multiple mechanisms. Herein, we show that interference with proline isomerization in HER2/EGFR overexpressing cells also induces cancer cell death. The peptidyl-prolyl isomerase inhibitor Cyclosporine A (CsA) selectively kills EGFR+ or HER2+ breast cancer cells in vitro by activating caspase-dependent apoptotic pathways. Further, CsA synergizes with the DDA tcyDTDO to kill HER2/EGFR overexpressing cells in vitro and the two agents cooperate to kill HER2+ tumors in vivo. There is a critical need for novel strategies to target HER2+ and EGFR+ cancers that are resistant to currently available mechanism-based agents. Drugs that target HER2/EGFR protein folding, including DDAs and CsA, have the potential to kill cancers that overexpress EGFR or HER2 through the induction of proteostatic synthetic lethality.

El continuo incremento de la obesidad en niños constituye un importante problema de salud que requiere de la identificación precisa de su magnitud y tendencias. Objetivo: Establecer la prevalencia de obesidad en escolares del Centro Básico Ingeniero Luis Bográn (CBILB) y el Centro de Educación Básica Marco Aurelio Pinto (CEB- MAP) en el mes de agosto del año 2015. Pacientes y métodos: Se realizó un estudio descriptivo, de corte transversal, durante el mes de agosto del año 2015, en escolares de dos Centros Básicos simultáneamente, el Centro Básico Ingeniero Luis Bográn, ubicado en la comunidad de Gualjoco, Santa Bárbara y el Centro de Educación Básica Marco Aurelio Pinto, ubicado en la comunidad de El Coowle, San Manuel, Cortés. Mediante muestreo probabilístico aleatorio estratificado se obtu- vo 154 y 93 escolares respectivamente, los cuales fueron evaluados antropométricamente. Los datos se analizaron mediante PASSW Statistics 18. Resultados: Se encontró que la prevalencia de obesidad en CBILB fue de 12.3%, siendo más frecuente en mujeres (7.14%) y en edades entre 9-11 años (7.79%) y en el CEBMAP fue de (6%), siendo más frecuente en hombres (7%). Conclusiones: La prevalencia de obesidad en escolares es significativa y varía según sexo y edad. Palabras clave Desarrollo infantil, Obesidad, Prevalencia

Introduction: Intractable pain following calcaneal fracture is a rare, but debilitating complication for a patient. The aim of this study was to assess if a double axonal crush with deep peroneal nerve (DPN) implantation is effective in alleviating residual intractable pain following surgical repair of Sanders III and IV calcaneal fractures. Methods: Eleven patients underwent DPN resection, double axonal crush, and bone implantation for entrapment of the distal portion of the DPN confirmed via EMG with a mean follow-up period of 26 months. The Visual Analog Scale and Quality of Life were used as scoring systems. Results: Results show a statistically significant (p Discussion: DPN resection, double axonal crush, and implantation into the tibia offers promising results, and further studies may be warranted to confirm as a valid treatment option.

Regenerative medicine is a resource to restore structure and function to damaged tissues and organs, and to support the body’s own healing mechanisms. For surgeons, intraoperative cell therapies that integrate autologous cell-based therapy with surgical interventions are aiding patients in their own recovery. Intraoperative cell therapy includes tissue harvesting and processing in combination with surgical techniques and the cell-derivative application. The purpose of this paper is to provide the technique for obtaining bone marrow aspirate during surgery, and it’s applications in surgical interventions that include bone lengthening and arthrodesis, muscular transpositions, and micro peripheral nerve reconstruction.

Reconstruction of traumatic composite bone and soft tissue loss (TCBSTL) employs several approaches among which is the bone transport (BT). In this procedure a healthy bone segment is mobilized by means of an external fixator to bridge a bone gap. Mobilization of the bone segment entails advancement of the overlying soft tissue envelop altogether. Between the year 2000 and 2017 the authors have treated 150 cases of TBSTL using distraction histogenesis and external skeletal fixation in all cases. The procedure was performed in two modes, in the first group the transport was performed gradually by distraction-compression of the osteotomy and bone defect sites respectively. In the second group, the procedure was performed by acute shortening and re-lengthening (ASRL) technique. Skin grafts(STSG)were used in six cases (4%) and iliac crest bone graft(ICBG) in 42 cases (28%). No free vascularized tissue grafts were used in any case. No internal fixation was attempted in any case. A few problems have been met with during gradual bone transport, and were manageable without effect on the treatment course or final outcome. Based on our observations in this series, BT was defined as “Bone transport is an instrumented advancement of a local vascularized osteomyocutaneous flap to bridge bone and soft tissue defect either gradual or acute.” When perceived as an osteomyocutaneous flap, bone transport extends the umbrella of the reconstruction ladder to include cases where other procedures could not be safely employed. Bone transport, either gradual or acute, is a powerful tool in the armamentarium of Orthoplastic limb reconstruction.

10 legs in 10 patients with tibial (7) or common peroneal (3) chronic neuritis were treated with microscopic internal Neurolysis and a Hemi local muscle flap. All patients in this series had a positive electrodiagnostic testing, diagnostic nerve block, intractable leg pain and numbness involving the common peroneal and tibial nerve prior to operation. Range of follow up from the procedure was from 13 to 27 months. All legs showed post-operative improvement. NCVs improved by an average of 5.51 m/s and Amplitudes by 7 m/v. VAS scores improved to 2.1/10 postoperatively. Photos were used in an attempt to illustrate the anatomical structure and viable options for neurolysis with a local muscle flap.

Circular external fixation offers an important option for reconstructive surgeons. When the soft tissue envelope is compromised, either by disease or trauma, external fixation offers a chance to address limb abnormalities that may otherwise be delayed. The application of the Iizarov apparatus requires skills and experience to address unique scenarios, starting prior to surgery and extending months following application. This article will offer practical management concepts based on the authors’ experience using the Orthofix Truelok system. It is our hope that the information provided will lend to improved management strategies and outcomes for the practitioner and patient.

The evolution of microsurgery and orthoplastics has expanded our ability as surgeons to manage complex lower extremity soft tissue defects. This evolution relies on the understanding of reconstructive surgical principles for problem solving and analyzing outcomes. The purpose of this review is to determine flap selection with a focus on reliability based on the outcomes of lower extremity free tissue transfer versus vascularized perforator pedicle flap transfer in lower limb reconstruction. A systematic literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using the databases PubMed/MEDLINE. Data were compiled by reviewing the number of patients, age, comorbidities, complications, size and location of defect. Outcomes were analyzed by indicated soft tissue defect size, location and cause, as well as subsequent flap size, type, survival, durability and their functional results. Overall, 72 topic related studies from 2014–2017 were reviewed. Sixteen of the 72 met the final inclusion criteria. Patient study sizes from the included articles ranged from 7–428 cases. The current qualitative systematic review of flap transfer in the lower extremity has contributed a summary of reported outcomes in literature thus far. After analyzing existing evidence, our study found no significant differences between reconstructive options with a paucity of evidence to clearly recommend the ideal flap transfer for microsurgical reconstruction of lower extremity soft tissue defects.

The reverse sural nerve flap is one of many versatile neuro-fasciocutaneous techniques available for staged reconstruction of lower limb and foot. It has been utilized to correct tissue defects often caused by traumatic injury, infection and even tumor resection. These tissue voids create challenges to the limb preservation surgeon as viable, rapid coverage of these areas is often paramount to successful long-term outcomes. The viability of these “axial pattern” flaps is predicated on the vascular supply and perfusion of the sensory superficial network and while this does not sacrifice a main arterial branch, it makes this flap more susceptible to failure with acute transposition along its arc of rotation. For this reason, a delayed method can be utilized to stage the procedure and increase the viability of the flap and provide more reliable successful outcomes.

As the number of total ankle replacement implantations performed in the United States continues to increase so does the development of associated complications to ensue. One of the major complications often encountered is that of periprosthetic infections, which tend to result in significant soft tissue defects relative to the distal one-third of the lower leg. In such cases, the soft tissue defects that arise create an extremely problematic situation for both patients and physicians combined, especially given the limited treatment options available to date. With that said, local tissue reconstruction with transpositional and reverse muscle flaps should always be considered regarding options for treatment. Here, we present the case of a 64-year- old woman with a past medical history of a prior bi-malleolar ankle fracture ORIF with subsequent post-traumatic ankle arthritis. Due to the patient’s post-traumatic symptoms, a total ankle replacement was performed. This case outlines how a reverse transpositional lateral hemi-soleus muscle flap was successfully implemented for the management and treatment of a distal anterior soft tissue ankle defect with exposed tendon status-post total ankle arthroplasty.

Objectives High-resolution ultrasonography (US) can play an important role in studying nerves, as it has several advantages. Entrapments of distal tibial nerve branches can be mapped out or diagnosed with selective anesthetic blocks, and US can guide therapeutic procedures, such as radiofrequency ablation and selective infiltrations of specific nerve branches. The aim of this study was to verify that US is an effective method for accurately locating the posterior tibial nerve and its terminal branches, such as the medial calcaneal branch, the first calcaneal branch, and the medial and lateral plantar nerves. Methods In this study, we analyzed the correlation between US mapping and real anatomy after cadaveric dissection, assessing the distribution and variability of the tibial nerve and its terminal branches. We used 12 fresh anatomic specimens of the foot and ankle, including the calf. A high-resolution US study of the tibial nerve and its branches was performed. Results The results of the US studies of the anatomic specimens were drawn as paper diagrams and in data collection tables. Both were completed twice per anatomic specimen, first using the results of the US study and second using the results from dissection of the anatomic specimens; this approach enabled us to compare the results and verify whether the US study and the dissection correlated on the topography of the tibial nerve and its terminal branches. We found almost total agreement between the US and dissection results, with no significant differences between the evaluations. Conclusions On the basis of this work, we can conclude that high-resolution US is almost 100% effective as a tool for identifying the tibial nerve and its branches, enabling the specialist to make diagnoses or perform selective treatments on each nerve branch and even to design surgical interventions by observing the patient's anatomy before performing the dissection.

Physiological and pathological mechanisms that determine subfertility (pregnancy failure, irregular cycles, and abnormalities in reproductive tract) in old mares (OM) have being studied by many authors. However, some young mares also share this reproduction condition although no previous reports have being published. We decided to investigate reproductive parameters of young subfertile mares (YSM) in order to understand the basis of their reproductive behavior. Forty-nine subfertile mares were classified and separated into 2 groups: YSM (3–10 years old; n = 28) and OM (13–23 years old; n = 21). Different number of cycles (1–8) was used for data analysis on the embryo recovery rate (ERR), interovulatory interval (IOI), multiple ovulation rate (MOR) and plasmatic progesterone. Embryo quality was evaluated by gene expression through RNAm analysis. Effluent samples were taken for bacteriological and cytological evaluation and endometrial biopsies were performed to evaluate the presence of inflammatory cells and endometrial progesterone receptors (PR). There was no significant differences in ERR (P =.1230) on the percentage of each embryonic stage found on the different days of flushing (P >.05); on embryo gene expression (P >.05); on MOR (P =.1218); and on plasmatic progesterone at day 8 PO (P =.1230). However, differences were found on the percentage of positive cytologies (P =.0122) and bacteriological cultures (P =.0023); the amount of mononuclear cells in biopsies (P

Background The purpose of this study is to report on the rehabilitative outcomes associated with common peroneal nerve (CPN) decompression and neurolysis revision when performed with open surgical implantation of a viable cryopreserved placental membrane (vCPM). Methods Seven patients who underwent secondary CPN decompression and neurolysis with open surgical implantation of a viable cryopreserved placental membrane (vCPM) after previously failed surgery without vCPM utilization were identified through a retrospective medical record review and outcomes were analyzed. Primary mechanism of injury, severity of symptoms at time of referral, pre-operative and post-operative evaluations on edema with ultrasound, Medical Research Council (MRC) scale for motor strength, range of motion, nerve conduction velocity (NCV), and electromyography (EMG) were analyzed. Results Five patients (71.4%) achieved full recovery of motor function MRC grade 5/5, and the remaining two patients achieved MRC grade 4/5. At the 7-month follow-up visit, NCV tests indicated improved conduction velocity and normal amplitude for all 7 patients, and all patients demonstrated proper gait pattern with a return to normal activities of daily living. There were no vCPM-related adverse events. Conclusions The use of vCPM wrap as an adjunct to surgical repairs of CPN injuries may contribute to positive clinical outcomes.

Medial plantar artery-based flaps have great value in healing full-thickness wounds of the foot and ankle. The goal of this study was to identify a common location for the origin of the medial plantar artery. Recognition of this anatomic marker will help improve incision placement and increase the success of preserving the artery when performing the medial plantar artery fasciocutaneous flap. This study examined the location of the origin of the medial plantar artery in 40 fresh cadavers. Results were obtained by dissection and macroscopic analysis to document the distance of the origin of the medial plantar artery from the intercollicular groove of the medial malleolus in centimeters. The mean distance was determined to be 3.2 ± 0.4 cm (range 2.7 to 4.5), with a low standard error of 0.0621. This suggests a high statistical probability that the common origin of the medial plantar artery is found 3.2 cm distal to the intercollicular groove of the medial malleolus in the general population.

Orthopaedics and plastics may resemble “acid and base”. But orthoplastic surgery is neither “acid” nor “base”. Orthoplastic surgery may resemble “salt”. And the future of orthoplastic surgery is dependent on further integration of these two fields.

Background Limb length discrepancy (LLD) in the setting of concurrent hindfoot and ankle deformity poses an added level of complexity to the reconstructive surgeon. Regardless of etiology, a clinically significant LLD poses additional challenges without a forthright and validated solution. The purpose of the current study is to determine whether reconstructive hindfoot and ankle surgery with concurrent lengthening through a distal tibial corticotomy is comparable to other treatment alternatives in the literature. Patients and methods A retrospective review of hindfoot and ankle deformity correction utilizing Ilizarov circular external fixation with concurrent distal tibial distraction osteogenesis from July 2009 to September 2014 was conducted. Results This study included 19 patients with a mean age of 47.47 ± 13.36 years with a mean follow up of 576.13 ± 341.89 days. The mean preoperative LLD was 2.70 ± 1.22 cm and the mean operatively induced LLD was 2.53 ± 0.59 cm. The mean latency period was 9.33 ± 3.47 days and distraction rate was 0.55 ± 0.16 mm/day. The mean distraction length was 2.14 ± 0.83 cm and mean duration of external fixation was 146.42 ± 58.69 days. The time to union of all hindfoot and ankle fusions was 121.00 ± 25.66 days with an overall fusion rate of 85.71%. Conclusions The successful treatment of hindfoot and ankle deformity correction in the setting of LLD using the technique of a distal tibial corticotomy and distraction osteogenesis is reported and illustrates an additional treatment technique with comparable measured outcomes to those previously described. We urge that each patient presentation be evaluated with consideration of all described approaches and associated literature to determine the current best reconstructive approach as future studies may validate or replace the accepted options at present.

It is well-documented that individuals with longstanding diabetes mellitus are at risk for specific metabolic abnormalities; this includes but is not limited to increased glycation of collagenous soft-tissue structures. It is also apparent that such changes can manifest as thickening and increased stiffness of tendinous structures. What remains unknown are the biomechanical ramifications of these changes and how they should affect the surgical management of lower extremity injuries. Previous research suggests that the Achilles tendon demonstrates increased stiffness in the presence of diabetes. It is therefore reasonable to presume that increased collagen glycation and the resultant tendon stiffness can also lead to decreased extensibility and shortening of the peroneus longus and brevis tendons. The significance of this leads us to the conclusion that glycation of the peroneal tendons can create a deforming force in displaced lateral malleolar fractures because of the adjacent position of the peroneal tendons relative to the lateral malleolus. Complications stemming from this can lead to increased difficulty in reducing fibular fractures and subsequent shortening of the fibula. For the purpose of this article, we present 2 cases, 1 using open reduction with internal fixation and the other with external fixation. We will demonstrate that, in both reduction methods, lengthening of the peroneal tendons can be a useful adjunct procedure to aid in restoration of fibular length in diabetic ankle fractures.

OBJECTIVES The purpose of the study was to determine whether ultrasound (US)-guided surgery is a viable type of surgery for performing an effective release/decompression of the constricting structures that are responsible for focal nerve compression in tarsal tunnel syndrome. METHODS Ultrasound guidance was used on cadaveric specimens to delineate the anatomic course of the nerves and vessels in the medial ankle that comprise the structures involved in tarsal tunnel syndrome. Ultrasound guidance was used on cadaveric specimens and assisted in delineating a safe surgical zone to adequately and effectively release these constrictive structures of the proximal and distal tarsal tunnels. The US-guided tarsal tunnel release/decompression was performed through 2 small 1- to 2-mm portals. After US-guided release, anatomic dissection was used to check the efficacy (release of the flexor retinaculum and deep abductor hallucis muscle) and safety (absence of neurovascular or tendon injury) of the procedure. RESULTS In 12 fresh cadaveric specimens, US-guided release of the tibial nerve (proximal tarsal tunnel) and its branches (distal tarsal tunnel) at the medial ankle was effective in all 12 specimens (100% release rate), without any signs of compromise or injury into the neurovascular structures. CONCLUSIONS Ultrasound-guided tarsal tunnel release is a feasible surgical procedure that can be safe and effective with the proper training, although further investigation is warranted. This type of surgery may promote faster recovery with less postoperative morbidity, including pain, but this will be the subject of a further investigation.