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  • Title: [Surgical treatment of tarsal tunnel syndrome in diabetic neuropathy].
    Author: Mazilu G, Budurcă RA, Graur M, Stamate T.
    Journal: Rev Med Chir Soc Med Nat Iasi; 2012; 116(1):128-34. PubMed ID: 23077884.
    Abstract:
    UNLABELLED: Posterior tibial nerve decompression surgery in tarsal tunnel syndrome in patients with diabetic neuropathy reduces pain, improves sensitivity and prevents foot ulcers and lower leg amputations. AIM: To observe and assess the recovery of plantar sensitivity recovery and the healing of ulcerative lessions of the foot, by clinical examination, exploration and analysis of quantitative neurosensory by surgical decompression of the tarsal tunnel. MATERIAL AND METHODS: We evaluated a total of 10 patients and 12 symptomatic diabetic neuropathy feet in a prospective clinical study, surgically treated in the Clinic of Plastic Surgery and Reconstructive Microsurgery Iaşi, during January 2008 - June 2011, where we practiced tibial nerve decompression and neurolysis in tarsal tunnel syndrome. RESULTS: Gender distribution of patients in the study group was predominantly male (60%), the ratio M/F = 1.5/1. Posterior tibial nerve decompression surgery resulted in recovery of plantar foot sensitivity in 90% patients in the study group. Testing Semmes-Weinstein 10 g monofilament was positive in 83.3% of the feet preoperatively whereas postoperatively only 25%, distribution of statistically significant (chi2 = 6.04, GL = 1, p = 0.014). Postoperative score to test a range of Riedel-Seiffer returned to normal in all patients: score 7 to 58.3% and score 8 to 41.7% of total standing tested. CONCLUSIONS: Tarsal tunnel decompression in diabetic patients with peripheric neuropathy improves plantar sensitivity, leads to healing of ulcerative plantar lesions and improves quality of life and should be performed in all patients with diabetic peripheral neuropathy in which conservative and/or medical treatment failed.
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