Microsurgical decompression of peripheral nerves for treatment of diabetic peripheral neuropathy of upper li+mbs

Abstract

Objective To study the effectiveness of microsurgical decompression of peripheral nerves for treatment of diabetic peripheral neuropathy of lower limbs.Methods The microsurgical decompression of common peroneal nerve,deep peroneal nerve,posterior tibial nerve and its branches were performed on 54 lower limbs of 42 diabetic patients with diabetic peripheral neuropathy (DPN).Results All the patients were followed-up for 40 months in average.The symptoms of numbness and pain were improved in 48 of 54 lower limbs (89％,48/54).70％ of the patients with preoperative balance problems were improved (21/30).The two points discrimination of 40 sides (74％,40/54)of limbs were improved.The conduction velocity and amplitude of action potential of common peroneal nerves and/or posterior tibial nerves of 38 sides (70％,38/54) of limbs were improved after the surgery.There was no refractory ulceration or amputation occurred in 54 lower limbs during follow-up duration.Delayed wound healing was found in 3 lower limbs (6％,3/54).Conclusions Microsurgical decompression of peripheral nerves is an effective method for the treatment of diabetic peripheral neuropathy of lower limbs.Strict preoperative patient selection and complete intro-operative decompression are key points for good postoperative results. Key words: Diabetic peripheral neuropathy; Peripheral nerves; Microsurgical decompression; Lower limbs