Surgical Tutorial – Tarsal Tunnel Release. Tarsal tunnel syndrome describes the compression of the tibial nerve through the tarsal tunnel which results in pain and numbness in the plantar aspect of the foot. The tibial nerve has three major branches which include the calcaneal, medial plantar, and lateral plantar nerve branches. There are two primary structures responsible for compression of the tibial nerve: (1) flexor retinaculum and (2) a septum that compartmentalizes the medial and lateral plantar nerves and the overlying fascia of the abductor hallucis muscle. The tarsal tunnel release involves releasing these structures. In this case, the patient had a traumatic injury to the lower leg, which required open reduction and internal fixation. The patient had pain and numbness in the tibial nerve distribution along with Tinel's sign and positive scratch collapse at the tarsal tunnel.