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Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities
BACKGROUND: Peripheral nerve involvement results in deformities in leprosy. High doses (40-60 mg) of steroids along with anti-leprosy drugs is the preferred treatment, even though 70-75% cases still develop deformity. Early surgical decompression of nerves gives better chances of preventing deformit...
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Formato: | Texto |
Lenguaje: | English |
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Medknow Publications
2008
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759596/ https://www.ncbi.nlm.nih.gov/pubmed/19823660 http://dx.doi.org/10.4103/0019-5413.38586 |
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author | Husain, Sajid Mishra, Birjendra |
author_facet | Husain, Sajid Mishra, Birjendra |
author_sort | Husain, Sajid |
collection | PubMed |
description | BACKGROUND: Peripheral nerve involvement results in deformities in leprosy. High doses (40-60 mg) of steroids along with anti-leprosy drugs is the preferred treatment, even though 70-75% cases still develop deformity. Early surgical decompression of nerves gives better chances of preventing deformity. We have analyzed the role of early surgical decompression in such cases. MATERIALS AND METHODS: Five hundred nerves (386 ulnar, 60 median and 54 posterior tibial) not responding to the medical treatment in 12 weeks, were undertaken for external and internal nerve trunk decompression. These cases were followed up for five to 20 years at various intervals. RESULTS: The pain in nerve (neuralgia) recovered in all cases of ulnar, median and posterior tibial nerves. Full sensory recovery to pinprick and feather or cotton wool touch was seen in 50% cases of all the three nerves. Twenty percent cases maintained the preoperative levels of sensory status. Plantar ulcers healed within six months after decompression of posterior tibial nerve but six cases showed recurrence. Overall motor recovery in ulnar nerve was 89% and 70% in median nerve. CONCLUSIONS: The sensory recovery restores protective sensation which prevents secondary injuries. The improvement of motor power gives better function and improves the appearance, which in the absence of surgical intervention was not possible. |
format | Text |
id | pubmed-2759596 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | Medknow Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-27595962009-10-09 Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities Husain, Sajid Mishra, Birjendra Indian J Orthop Original Article BACKGROUND: Peripheral nerve involvement results in deformities in leprosy. High doses (40-60 mg) of steroids along with anti-leprosy drugs is the preferred treatment, even though 70-75% cases still develop deformity. Early surgical decompression of nerves gives better chances of preventing deformity. We have analyzed the role of early surgical decompression in such cases. MATERIALS AND METHODS: Five hundred nerves (386 ulnar, 60 median and 54 posterior tibial) not responding to the medical treatment in 12 weeks, were undertaken for external and internal nerve trunk decompression. These cases were followed up for five to 20 years at various intervals. RESULTS: The pain in nerve (neuralgia) recovered in all cases of ulnar, median and posterior tibial nerves. Full sensory recovery to pinprick and feather or cotton wool touch was seen in 50% cases of all the three nerves. Twenty percent cases maintained the preoperative levels of sensory status. Plantar ulcers healed within six months after decompression of posterior tibial nerve but six cases showed recurrence. Overall motor recovery in ulnar nerve was 89% and 70% in median nerve. CONCLUSIONS: The sensory recovery restores protective sensation which prevents secondary injuries. The improvement of motor power gives better function and improves the appearance, which in the absence of surgical intervention was not possible. Medknow Publications 2008 /pmc/articles/PMC2759596/ /pubmed/19823660 http://dx.doi.org/10.4103/0019-5413.38586 Text en © Indian Journal of Orthopaedics http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Husain, Sajid Mishra, Birjendra Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities |
title | Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities |
title_full | Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities |
title_fullStr | Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities |
title_full_unstemmed | Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities |
title_short | Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities |
title_sort | decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759596/ https://www.ncbi.nlm.nih.gov/pubmed/19823660 http://dx.doi.org/10.4103/0019-5413.38586 |
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