title: The ultrasonographic evaluation of hemodynamic changes in patients with diabetic polyneuropathy after tarsal tunnel decompression.
abstract: BACKGROUND
  Nerve decompression procedures have shown to have promising roles in patients with diabetic polyneuropathy. It is known that not only nerves but also arteries pass through the same compressed anatomical tunnels. The aim of the study is to reveal whether the surgical decompression procedures have a positive effect on hemodynamic and morphological parameters of the arterial structures passing through these anatomic tunnels.
  
  
  METHODS
  Twenty-seven patients who underwent posterior and anterior tarsal tunnel release procedures were retrospectively scanned for preoperative and 3 months postoperative arterial Doppler ultrasound imaging. The preoperative and third month postoperative measurements were compared for flow pattern of artery, flow lumen diameter, pulsatility index (PI), resistance index (RI), and flow volumes by evaluating the hemodynamic and morphological parameters of dorsalis pedis (DPA) and tibialis posterior arteries (TPA).
  
  
  RESULTS
  For TPA, mean PI values were 5.76 ± 2.78 preoperatively, 7.17 ± 3.08 postoperatively. Mean RI values were 0.94 ± 0.04 preoperatively and 0.89 ± 0.05 postoperatively. For DPA, mean PI values were 5.06 ± 2.14 preoperatively and 6.35 ± 2.31 postoperatively. Mean RI values were 0.93 ± 0.05 preoperatively and 0.86 ± 0.06 postoperatively. When the results are analyzed for both of the arteries, PI values were significantly increased; RI values were significantly decreased when the preoperative measurements were compared with the postoperative measurements (P < 0.05).
  
  
  CONCLUSIONS
  According to these results, it can be suggested that the nerve release procedures have a positive effect on the hemodynamic and morphological parameters of the arteries as they pass through the anatomical tunnels as well as its positive effects on the neurological functions of the entrapped nerves.
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Tekin
authors.affiliation: Department of Radiology, Pamukkale University Medical Center, Denizli, Turkey.
authors.forename: Kadir
authors.initials: K
authors.lastname: Ağladioğlu
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sürmeli
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Candemir
authors.initials: C
authors.lastname: Ceran
authors.affiliation: Department of Neurology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey.
authors.forename: Hesna
authors.initials: H
authors.lastname: Bektaş
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet Çağatay
authors.initials: MÇ
authors.lastname: Falcioğlu
authors.affiliation: Department of Radiology, Inönü University Turgut Özal Medical Center, Malatya, Turkey.
authors.forename: Ismail Okan
authors.initials: IO
authors.lastname: Yildirim
authors.affiliation: Department of Plastic Reconstructive and Aesthetic Surgery, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Ömer Faruk
authors.initials: ÖF
authors.lastname: Taner
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries; D019299:Decompression, Surgical; D003929:Diabetic Neuropathies / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010543:Peroneal Nerve / Q000601:surgery; D012189:Retrospective Studies; D013641:Tarsal Tunnel Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013979:Tibial Nerve / Q000601:surgery; D018608:Ultrasonography, Doppler