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Dellon. Plast Aesthet Res 2022;9:45 https://dx.doi.org/10.20517/2347-9264.2022.13 Page 9 of 15

Figure 5. The deep peroneal nerve has been released over the dorsum of the foot by resecting the extensor digitorum brevis to the
hallux. This tendon compresses the underlying nerve against the cuneiform bone.

Table 1 contains the results of their study. On average, just 35% of health care practitioners were aware of
this approach and just 9% appreciated its value. Only 3% of these health care providers referred patients to a
surgeon for the surgical approach. This study was done in the Netherlands, where the first randomized
control study was reported using the Dellon Approach.

The questions to be addressed today are “How can we best educate those health care professionals
throughout the world to learn that (1) diabetics have an increased prevalence of chronic nerve
compressions, (2) how to diagnose a chronic nerve compression, and (3) how to train surgeons interested in
doing these procedures? I am hopeful that through a program aimed at providing this information to
medical students early in their educational curriculum, an approach described elsewhere in an article in this
issue of this journal, the future may hold optimism for those suffering from diabetic neuropathy .
[83]

CONCLUSION
The current evidence is overwhelmingly clear, in diabetics with neuropathy and a positive Tinel sign over
the tibial nerve at the tarsal tunnel, that decompression, by neurolysis of lower extremity nerves, can relieve
pain, restore sensation, and prevent ulceration and amputation. Furthermore, lower extremity nerve