Changing the natural history of diabetic neuropathy: Incidence of ulcer/amputation in the contralateral limb of patients with a unilateral nerve decompression procedure

Oscar Aszmann, Patsy L. Tassler, A. Lee Dellon

Research output: Contribution to journalArticlepeer-review

Abstract

The natural history of diabetes neuropathy is progressive and irreversible loss of sensibility in the feet, leading to ulceration and/or amputation in 15% of patients. The prevalence of neuropathy is more than 50% in those who have been diabetic for 20 years. Decompression of the tibial and peroneal nerves in those with diabetic neuropathy improves sensation in 70% of patients. The impact of this surgery on the development of ulcers and amputations in both the operated and the contralateral, nonoperated limb was evaluated in a retrospective analysis of 50 patients with diabetes a mean of 4.5 years (range, 2-7 years) from the date of surgery. No ulcers or amputations occurred in the index limb of these patients. In contrast, there were 12 ulcers and 3 amputations in 15 different patients in contralateral limbs. This difference was significant at P < 0.001. It is concluded that decompression of lower extremity nerves in diabetic neuropathy changes the natural history of this disease, representing a paradigm shift in health care costs.

Original languageEnglish (US)
Pages (from-to)517-522
Number of pages6
JournalAnnals of plastic surgery
Volume53
Issue number6
DOIs
StatePublished - Dec 2004

Keywords

  • Decompression
  • Diabetes
  • Neuropathy
  • Tarsal tunnel
  • Ulceration

ASJC Scopus subject areas

  • Surgery

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