The Role of Peripheral Nerve Surgery in Diabetic Limb Salvage

Abstract

Review of available reports in the surgical literature demonstrates that the results of peripheral nerve surgery are promising for the prevention of limb loss in chronic diabetes mellitus, for diminishment of pain, and for restoration of sensory/motor function.

Evaluation of peripheral microcirculation improvement of foot after tarsal tunnel release in diabetic patients by transcutaneous oximetry

“…Increased pressure has been documented intraoperatively in the medial and lateral plantar tunnels in patients with diabetic neuropathy . Nerve compression causes compression of the vasa nervorum, thus leading to distal nerve ischemia, and decreased axoplasmic flow . This impairs the ability of the nerve to communicate with muscle fibers and skin mechanoreceptors, resulting in loss of function or sensation.…”

Preface to Current Concepts in Wound Healing: Update 2011

“…21 The article and the following discussions help put nerve surgery in perspective. Restoring some degree of sensation is critical in preventing further injury.…”

The ultrasonographic evaluation of hemodynamic changes in patients with diabetic polyneuropathy after tarsal tunnel decompression

“…The conversion of glucose to sorbitol and the final increase in the intracellular osmotic pressure by sorbitol causes an increase in the intraneural water content which becomes evident as “nerve edema” . Nerve edema is thought to cause nerve entrapment in the anatomical tunnels that are enclosed by nonexpendable rigid walls that directly cause a pressure increase throughout the tunnel …”