Surgical decompression of posterior tibial neurovascular complex in treatment of certain chronic plantar ulcers and posterior tibial neuritis in leprosy.

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TitleSurgical decompression of posterior tibial neurovascular complex in treatment of certain chronic plantar ulcers and posterior tibial neuritis in leprosy.
Publication TypeJournal Article
AuthorsPalande DD, Azhaguraj M
Abbrev. JournalInt. J. Lepr. Other Mycobact. Dis.
JournalInternational journal of leprosy and other mycobacterial diseases : official organ of the International Leprosy Association
Year of Publication1975
Volume43
Issue1
Pagination36-40
Publication Languageeng
KeywordsAdolescent, Adult, Female, Foot, Foot Diseases, Humans, India, Leprosy, Male, Methods, Middle Aged, Neuritis, Tibial Nerve, Ulcer
Abstract

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.

PubMed URL

http://www.ncbi.nlm.nih.gov/pubmed/1171829?dopt=Abstract

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