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Changing the Natural History of Diabetic Neuropathy: Incidence of Ulcer/Amputation in the Contralateral Limb of Patients With a Unilateral Nerve Decompression Procedure.
Ann Plast Surg. 2004 Dec;53(6):517-522 Aszmann O, Tassler PL, Dellon AL.
Quote:
The natural history of diabetes neuropathy is progressive and irreversible loss of sensibility in the feet, leading to ulceration and/or amputation in 15% of patients. The prevalence of neuropathy is more than 50% in those who have been diabetic for 20 years. Decompression of the tibial and peroneal nerves in those with diabetic neuropathy improves sensation in 70% of patients. The impact of this surgery on the development of ulcers and amputations in both the operated and the contralateral, nonoperated limb was evaluated in a retrospective analysis of 50 patients with diabetes a mean of 4.5 years (range, 2-7 years) from the date of surgery. No ulcers or amputations occurred in the index limb of these patients. In contrast, there were 12 ulcers and 3 amputations in 15 different patients in contralateral limbs. This difference was significant at P < 0.001. It is concluded that decompression of lower extremity nerves in diabetic neuropathy changes the natural history of this disease, representing a paradigm shift in health care costs.
What say you?
Last edited by Admin : 17th December 2004 at 05:14 PM.
The Report on Nerve Decompressionlooks impressive.However in Diabetes the neuropathy is multifactorial and not only compressive.Many a times the decompression does not help.There is need for wider debate and well controlled trials to assess the genuine benifit of this therapy
Last edited by Admin : 27th December 2004 at 06:26 PM.
Changing the Natural History of Diabetic Neuropathy: Incidence of Ulcer/Amputation in
Although this is one of several basic retrospective papers on nerve decompression in diabetes to reverse neuropathic symptoms...I continue to have a gut feeling there might be something in this approach. I am constantly amazed at the huge numbers of diabetic patients that have bilateral carpal tunnel releases under the diagnosis of "carpal tunnel syndrome", in the presence of foot-related "diabetic peripheral neuropathy". These people go really well with there carpal tunnel releases, but everyone writes of the foot as a lost cause that cannot be treated. Don't write this one off just yet guys and gals.
Some bold claims on changing diabetic foot natural history
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