Treatment of Decompression of Peripheral Nerves

by
A. Lee Dellon, MD
July 2004 ASSH Correpsondence News

I wanted to let you all know that the techniques worked out for the treatment of decompression of peripheral nerves in the upper extremity work well in the lower extremity too.  Most importantly, I want to let you know of the success of decompressing nerves in the legs in order to recover sensation, relieve pain, and prevent ulcers and amputation in patients with diabetic neuropathy.

In the early 1980's, many diabetics, upon whom I had decompressed their carpal tunnel, would ask me to help recover the sensation in their feet. Ultimately, I realized that the tarsal tunnel represented the forearm, and described the medial plantar tunnel as representing the carpal tunnel. This led to an approach that has now been duplicated by many other surgeons. In June, 2004, a review article was published in the Foot and Ankle Clinics of North America (9:239-254, by Kent Biddinger, MD). Dr Biddinger's success using my technique led to 80% of patients having relief of pain and recovery of sensation.

Below is a chart (see Table 1 below) of the other papers in the literature and their reported success rates. In brief, if a patient with symptoms of neuropathy, diabetic or neuropathy of unknown etiology, and they have a positive Tinel sign over the tibial nerve in the tarsal tunnel, then there is an 80% chance they will have relief of their pain, 80% chance their will have recovery of sensibility, and if these occur they will not develop an ulcer or have an amputation. No diabetic I have operated upon has developed an ulcer or had an amputation.  References are available on request, by email: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

The public information website neuropathyregistry.com has an ongoing statistical data base for the more than 190 surgeons who have taken one of our past 17 Advanced Lower Extremity Peripheral Nerve Workshops. The information for the Dellon Institutes of Peripheral Nerve Surgery? is at dellonipns.com, with patient information brochures that can be downloaded on this subject and a map of the U.S.A. showing where these surgeons are in 38 states, and of the world, where this is being done in 12 other countries.