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. Of these patients, 465 (74%) had VAS >5. Each patient had a release of the tarsal tunnel and a neurolysis of the medial and lateral plantar and calcaneal tunnels. Subsequent, contralateral, identical surgery was done in 211 of the patients (152 of which had a VAS >5). Mean VAS score decreased from 8.5 to 2.0 (p <0.001) at 6 months, and remained at this level for 3.5 years. Sensibility improved from a loss of protective sensation to recovery of some two-point discrimination during this same time period. It is concluded that a positive Tinel sign over the tibial nerve at the tarsal tunnel in a diabetic patient with chronic nerve compression at this location predicts significant relief of pain and improvement in plantar sensibility.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1055/s-0032-1306371 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Case Series of Traumatic Peripheral Nerve Injuries in Pediatric Patients Treated with Allograft Repair.
J Hand Surg Glob Online
November 2024
Department of Orthopedic Surgery, Texas Tech University of Health Sciences Center, Lubbock, TX.
Purpose: In the adult literature, allograft reconstruction of gapped peripheral nerve injuries has gained popularity over autologous nerve grafting. Allografts have demonstrated similar recovery while eliminating donor site morbidity. There is no well-defined incidence or treatment of such injuries in children.
View Article and Find Full Text PDFSchwannoma of the Ankle: A Case Report of a Rare Clinical Entity.
Cureus
October 2024
Orthopedics, Unidade Local de Saúde do Tâmega e Sousa, Porto, PRT.
A schwannoma is a soft tissue benign tumor that originates from Schwann cells of the peripheral nerve sheath. It is uncommon for it to occur in the foot. The tumor usually has an indolent presentation with a delayed diagnosis that may lead to irreversible nerve damage.
View Article and Find Full Text PDFOutcomes of Oberlin Transfer in Elderly Patients: A Case Series.
World Neurosurg
December 2024
Division of Neurosurgery, Department of Surgery, Gaffrée and Guinle University Hospital, School of Medicine, Federal University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil.
Objective: A case series analysis was performed of upper brachial plexus injuries (BPIs) from low-impact trauma in patients ≥60 years old to assess the effectiveness of nerve transfers, particularly the Oberlin technique, in restoring elbow flexion and to refine clinical decision making for managing traumatic BPIs in this age group.
Methods: Between 2013 and 2024, 11 patients aged 60-72 with traumatic upper BPIs underwent Oberlin technique for elbow flexion; all were evaluated with consistent postsurgical criteria.
Results: Trauma mechanisms included falls (55%), direct trauma (27%), knife wounds (9%), and stretching (9%), with no high-impact trauma cases.
Efficacy of Neuromuscular Ultrasound in Diagnosing and Treating a Mammogram-Induced Brachial Plexus Injury-A Case Report.
J Clin Ultrasound
November 2024
Department of Rehabilitation Medicine, Neuromusculoskeletal Institute, Rowan-Virtua School of Osteopathic Medicine, Sewell, New Jersey, USA.
A 40-year-old woman presented with chronic left anterior shoulder, upper arm, and axillary pain following a routine mammogram 3 years prior. Despite multiple interventions, her pain persisted significantly affecting her quality of life. Ultrasound examination revealed fascicular edema in the medial brachial cutaneous nerve (MBCN), intercostobrachial cutaneous nerve (ICBN), and a positive sono-Tinel.
View Article and Find Full Text PDFDouble Crush Syndrome in the Lower Extremity: Simultaneous L5 Radiculopathy and Common Peroneal Nerve Compression.
World Neurosurg
December 2024
Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.
Background: Double crush syndrome (DCS) is defined as multiple sites of compression along a single nerve. The combination of a compressive proximal lesion in the lumbar spine and a distal common peroneal nerve entrapment may result in compound nerve dysfunction.
Methods: A retrospective analysis of 100 patients who underwent common peroneal nerve decompression with a diagnosis of L5 radiculopathy between January 2000 and April 2023 at two quaternary academic institutions was performed.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!