Effect of surgical decompression of nerves in the lower extremity in patients with painful diabetic polyneuropathy on stability: a randomized controlled trial.
OBJECTIVE
To investigate the effect of decompression of nerves in the lower extremity in patients with painful diabetic polyneuropathy on static balance using a sensitive pressure mat system.


METHODS
Non-blinded randomized controlled trial.


METHODS
Single center study performed at the University Medical Center Utrecht between 2010-2013.


METHODS
Patients with painful diabetic polyneuropathy assessed with the Diabetic Neuropathy Symptom score and Diabetic Neuropathy Examination between 18-90 years. Exclusion criteria were: physical problems leading to instability, BMI>35 kg/m2, ankle fractures in history, amputations proximal to the tarsometatarsal joints, active foot ulcer(s), severe occlusive peripheral vascular diseases.


METHODS
Unilateral surgical nerve decompression at four sites in the lower extremity, the contralateral limb was used as control (within-patient comparison), with one year follow-up.


METHODS
Preoperatively and 6 and 12 months postoperatively, weight bearing and five variables of sway of the center of pressure were measured with a pressure mat with eyes open and eyes closed. T-test was used for evaluation of postoperative results.


RESULTS
Thirty-nine Patients met inclusion criteria and were enrolled for stability testing. Postoperatively no significant differences for sway variables and weight bearing were seen compared to preoperatively measurements.


CONCLUSIONS
There is no evidence that surgical decompression of nerves of the lower extremity influences stability within one year after surgery in patients with painful diabetic polyneuropathy.
Department of Plastic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands j.f.m.macare@umcutrecht.nl.
Joanne F M
JF
Macaré van Maurik
Department of Plastic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Britt
B
ter Horst
Department of Plastic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Mireille
M
van Hal
Department of Plastic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Moshe
M
Kon
Department of Medicine, VU university Medical Center, Amsterdam, The Netherlands.
Edgar J G
EJ
Peters
D019299:Decompression, Surgical; D003929:Diabetic Neuropathies / Q000601:surgery*; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000294:innervation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000601:surgery*; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D004856:Postural Balance / Q000502:physiology*
Diabetic polyneuropathy; diabetes mellitus; nerve decompression; postural balance; stability; surgery