Arolkar S K, Antia N H
Foundation for Medical Research 84-A, Bombay, India.
Lepr Rev. 1995 Mar;66(1):48-54. doi: 10.5935/0305-7518.19950007.
Traditional surgical decompression of the posterior tibial nerve yields equivocal results. The authors postulate that the posterior tibial artery is the most compromised structure in the neurovascular compartment and that the best surgical results in healing of plantar ulcers are achieved by the rechannelling of the blood flow in the posterior tibial artery during posterior tibial neurovascular compartment surgery. This procedure has been of benefit to patients with plantar ulcers of greater than 7-10 years' duration in whom all other modes of healing had failed. It has been undertaken as an outpatient procedure under local anaesthesia, supported by postoperative vasodilator drugs. The use of tourniquet, antibiotics and surgical interference with the ulcer per se was eschewed. A report of 156 patients is presented with follow-up of up to 6 years for the earlier cases.
传统的胫后神经减压手术效果并不明确。作者推测，在神经血管间隙中，胫后动脉是受影响最严重的结构，而在胫后神经血管间隙手术中，通过重新引导胫后动脉的血流，能在足底溃疡愈合方面取得最佳手术效果。该手术已使病程超过7至10年且其他所有愈合方式均告失败的足底溃疡患者受益。该手术在局部麻醉下作为门诊手术进行，术后辅以血管扩张药物。避免使用止血带、抗生素以及对溃疡本身进行手术干预。本文报告了156例患者的情况，对较早病例进行了长达6年的随访。
