01753nas a2200229   4500000000100000008004100001653001200042653002600054653002400080653001200104653002100116100001000137700001900147700001400166700001400180245008500194856011000279300000900389490000600398520110500404022001401509       2016                            d10aSurgery10aPeripheral neuropathy10aNerve decompression10aleprosy10aHand Deformities1 aWan E1 aRivadeneira AF1 aJouvin RM1 aDellon LA00aTreatment of peripheral neuropathy in leprosy: The case for nerve decompression.  uhttp://journals.lww.com/prsgo/Citation/2016/03000/Treatment_of_Peripheral_Neuropathy_in_Leprosy__.13.aspx  ae6370 v43 a<p>Plastic surgery has a tradition of caring for patients with facial deformity and hand deformity related to leprosy. The approach, however, to the progressive deformity and disability related to chronic nerve compression is underappreciated in the world today. A cohort of patients with leprous neuropathy from an indigenous area of leprosy in Ecuador was evaluated for the presence of chronic peripheral nerve compression, and 12 patients were chosen for simultaneous upper and lower extremity, unilateral, nerve decompression at multiple levels along the course of each nerve. The results at 1 year of follow-up show that 6 patients improved into the excellent category and 4 patients improved into the good category for improved function. Based on the early results in this small cohort of patients with leprous neuropathy, an approach to peripheral nerve decompression, encompassing the concept of multiple crush at multiple levels of each nerve, seems to offer optimism to improve upper and lower extremity limb function. Long-term studies with quality-of-life outcomes would be welcome.</p>
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