A positive Tinel sign as predictor of pain relief or sensory recovery after decompression of chronic tibial nerve compression in patients with diabetic neuropathy.

Predictive ability of a positive Tinel sign over the tibial nerve in the tarsal was evaluated as a prognostic sign in determining sensory outcomes after distal tibial neurolysis in diabetics with chronic nerve compression at this location. Outcomes were evaluated with a visual analog score (VAS) for pain and measurements of the cutaneous pressure threshold/two-point discrimination. A multicenter prospective study enrolled 628 patients who had a positive Tinel sign.

Prevention of ulceration, amputation, and reduction of hospitalization: outcomes of a prospective multicenter trial of tibial neurolysis in patients with diabetic neuropathy.

This is the first multicenter prospective study of outcomes of tibial neurolysis in diabetics with neuropathy and chronic compression of the tibial nerve in the tarsal tunnels. A total of 38 surgeons enrolled 628 patients using the same technique for diagnosis of compression, neurolysis of four medial ankle tunnels, and objective outcomes: ulceration, amputation, and hospitalization for foot infection. Contralateral limb tibial neurolysis occurred in 211 patients for a total of 839 operated limbs.

Digital tourniquets: a pressure study with clinical relevance.

This study measured the pressures under the three most commonly used digital tourniquets--the Penrose drain, the rolled rubber glove, and the rubber band. A miniature pressure transducer and a digital strain indicator were used to measure pressures generated by the various tourniquets. The rolled rubber glove technique was highly consistent, irrespective of the clinical experience of the subject, and uniformly generated pressures of less than 500 mm Hg.

Tattoo removal: comparative study of six methods in the pig.

Six methods of tattoo removal were compared on tattoos of the same design made on a pig by a professional tattoo artist. Once the tattoos were healed and mature, each method was tried three times at 3-week intervals. Biopsies were taken before and after the treatment was completed to determine the depth of the pigment.

Simplified technique for replantation of the thumb.

Replantation of the thumb is more difficult than that of the fingers since the palmar vessels are out of the plane of the hand. A simplified technique is presented, in which vein graft extensions are anastomosed to the proper digital vessels prior to osteosynthesis. Utilizing this technique, arterial reconstruction can proceed at a more rapid rate with fewer positioning problems.