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Surgical Decompression in Lower-Extremity Diabetic Peripheral Neuropathy

Andrew J. Rader Patoka Valley Podiatry, PC, Jasper, IN; Center for Wound Healing, 1900 Medical Arts Dr, St Joseph’s Hospital, Huntingburg, IN 47542.

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Peripheral neuropathy can be a devastating complication of diabetes mellitus. This article describes surgical decompression as a means of restoring sensation and relieving painful neuropathy symptoms. A prospective study was performed involving patients diagnosed as having type 1 or type 2 diabetes with lower-extremity peripheral neuropathy. The neuropathy diagnosis was confirmed using quantitative sensory testing. Visual analog scales were used for subjective assessment before and after surgery. Treatment consisted of external and as-needed internal neurolysis of the common peroneal, deep peroneal, tibial, medial plantar, lateral plantar, and calcaneal nerves. Subjective pain perception and objective sensibility were significantly improved in most patients who underwent the described decompression. Surgical decompression of multiple peripheral nerves in the lower extremities is a valid and effective method of providing symptomatic relief of neuropathy pain and restoring sensation. (J Am Podiatr Med Assoc 95(5): 446–450, 2005)