01845nas a2200313   4500000000100000008004100001260001700042653001500059653001000074653001100084653000900095653001800104653001100122653001000133653001200143653000900155653001200164653001600176653001300192653001700205653001000222100001600232700001600248245015800264300001000422490000700432520107800439022001401517       1975                            d  c1975 Jan-Mar10aAdolescent10aAdult10aFemale10aFoot10aFoot Diseases10aHumans10aIndia10aleprosy10aMale10aMethods10aMiddle Aged10aNeuritis10aTibial Nerve10aUlcer1 aPalande D D1 aAzhaguraj M00aSurgical decompression of posterior tibial neurovascular complex in treatment of certain chronic plantar ulcers and posterior tibial neuritis in leprosy.  a36-400 v433 a<p>Seventy-one cases of posterior tibial neurovascular surgical decompression in leprosy are analyzed and reviewed. Thirteen had chronic refractory posterior tibial neuritis while 58 had chronic nonhealing plantar ulcers. The plantar ulcers were associated with posterior tibial neuritis and/or vascular insufficiency. The clinical and operative findings together with the results are presented and the physiopathology of neurovascular compression is discussed. The operative procedure is described. The presence of pale granulation tissue in a nonhealing ulcer seems to be a characteristic finding in these cases. Neurovascular compression in the tunnel, behind and also below the malleolus, was present in all. In operative procedures, the importance of incising the inferior calcaneal bands is stressed. The results show that the neuritis was cured in all cases, while in 53 of 58 cases the plantar ulcers healed in a short period after the decompression. This stresses the value of this procedure. The prophylactic potential of this procedure needs to be evaluated.</p>  a0148-916X