Peroneal Nerve Research Articles

Iatrogenic Common Peroneal Nerve Injuries From Inside-out Lateral Meniscus Repair: A Report of 2 Cases.

We report 2 cases of common peroneal nerve (CPN) palsy after inside-out lateral meniscus (LM) repair with very different presentations, occurring despite the standard surgical precautions (open counter incision and proper retraction between the biceps femoris tendon, lateral gastrocnemius, and capsule). On exploration, needle was found to have penetrated the nerve in one case and the nerve sheath in the other case. Patient 1 had near-complete neurological recovery, while patient 2 had partial neurological recovery after suture removal and neurolysis. CPN palsy can occur despite following all precautions during LM repair and should be managed as an iatrogenic injury unless proven otherwise.

Effectiveness of Neuromuscular Taping on Balance, Proprioception, Pain, and Nerve Conduction Parameters in Patients with Diabetic Peripheral Neuropathy: A Two-Group Pretest–Posttest Randomized Sham-Controlled Trial: A Pilot Study

Abstract Aim: Neuromuscular Taping (NMT) is the application of elastic adhesive tape to the skin without any tension in it. NMT creates wrinkles on the surface of the skin to help stretch the skin passively and this elongation force assists in muscle contraction and relaxation. Therefore, this study aimed to assess the effectiveness of NMT in the improvement of sensorimotor complications following diabetic peripheral neuropathy (DPN). Setting and Design: A randomized controlled trial performed at a tertiary health care center. Materials and Methods: A total of 20 participants were recruited and were divided into two groups: The experimental group (EG; N = 10) and the control group (CG; N = 10). Eight weeks of physiotherapy intervention including NMT on bilateral tibialis anterior, tibialis posterior, peroneus longus muscles, transverse arch of the foot, and transcutaneous electrical nerve stimulation (TENS) on the course of bilateral tibial and peroneal nerves for EG. CG received sham taping and TENS as an EG group. The patients were assessed for pre- and post-intervention using the outcomes: Leeds Assessment of Neuropathic Signs and Symptoms and nerve conduction velocity of tibial, peroneal, and sural nerves and H-reflex, Berg Balance Scale, and Pedalo-Sensamove Mini Board. Results: The results revealed that both the groups showed significant improvements in all variables except for the H-reflex of the right and left sides at P > 0.05. EG showed more clinical and symptomatic improvement compared with CG. In EG, most of the variables showed moderate to large effect sizes ranging from 0.66 to 0.97 except for bilateral H-reflex; ranging from 0.15 to 0.33. Conclusion: This study concludes that NMT can be a trustworthy approach to treating DPN.

Peroneal Nerve Entrapment in Diabetes Mellitus.

This narrative mini-review discusses the association between peroneal nerve entrapment (PEN) and diabetes mellitus (DM). Generally, PEN is not a common cause of peripheral neuropathy in DM. Poor glycaemic control and DM duration are powerful risk factors for PEN. Underlying mechanisms involve neurodegeneration and entrapment of the peroneal nerve. Patients tend to present with chronic leg pain, gradual foot drop, steppage gait, or weakness of ankle dorsiflexion. Electrodiagnostic and imaging studies are very useful in diagnosis to determine the level at which entrapment occurs. Treatment varies based on the aetiology and severity of symptoms. It is initially conservative. Surgical nerve decompression management is required when entrapment is refractory to non-operative options.

Complete foot drop due to atypical peroneal ganglion in a 13 ½ year old boy

IntroductionPeroneal nerve palsy due to compression by an intraneural ganglion is an uncommon entity in the pediatric setting with a need for surgical treatment. Uniquely in this case, the ganglion presented as an elongated instead of a typical round cyst, delaying diagnosis and treatment. Case presentationWe present the case of a 13 ½ year old boy with increasing peroneal nerve palsy due to an atypically shaped intraneural ganglion. An MRI of the knee revealed an elongated peroneal ganglion compressing the nerve between the lateral insertion of the gastrocnemius muscle and fibular head over a length of 10 cm. After surgical decompression and physiotherapy the peroneal nerve recovered well, achieving M 4 – 5 one year after surgery. ConclusionThe atypical shape of the present peroneal ganglion delayed diagnosis and correct treatment. Though rare in the pediatric setting, this entity must be specifically looked for during the diagnostic workup of peroneal palsy, for time to surgery determines neurological outcome.

Unveiling the Role of Nerve Conduction Studies (NCS) in Detecting Subclinical Peripheral Neuropathy in Autoimmune Disorders: A Cross-Sectional Study.

Peripheral neuropathy, characterized by nerve damage, often presents with symptoms like pain, tingling, and muscle weakness. However, in its subclinical form, these symptoms may be subtle or absent, making early detection challenging. This is particularly concerning in patients with autoimmune connective tissue disorders (ACTDs), where the immune system attacks the body's tissues, potentially leading to nerve damage. Early identification and management are crucial to prevent the progression from subclinical to clinical neuropathy, which can significantly impair quality of life. This prospective cross-sectional study involved 100 patients with ACTDs of three or more years' duration, conducted at Saveetha Medical College over 15 months. Nerve conduction studies (NCS) were performed on bilateral ulnar, radial, sural, peroneal, and tibial nerves. Peripheral neuropathy was present in 18 (18%) of the study participants. Carpal tunnel syndrome was the most prevalent type, affecting 10 (55.56%) of those with neuropathy. Significant differences were found in the left peroneal motor nerve (p = 0.003) and right tibial nerve (p = 0.03) conduction times. Additionally, significant associations were observed between rheumatoid factor positivity (p = 0.011), anti-cyclic citrullinated peptide (anti-CCP) antibody status (p = 0.032), and the presence of peripheral neuropathy. This study underscores the importance of early detection and intervention for peripheral neuropathy in patients with ACTDs. The study's findings align with existing literature, suggesting that a substantial proportion of patients with ACTDs are at risk for peripheral neuropathy, particularly in older patients and those with specific autoimmune markers.Regular NCS assessments are recommended to identify at-risk individuals, potentially mitigating the progression of neuropathy and improving patient outcomes. Future research should include larger, more diverse populations and longitudinal studies to further validate these findings.

Ultrasound Guided Tibial and Common Peroneal Nerve Block in Donkey

Ultrasound Guided Tibial and Common Peroneal Nerve Block in Donkey

Deconstruction the feedforward inhibition changes in the layer III of anterior cingulate cortex after peripheral nerve injury

The anterior cingulate cortex (ACC) is one of the critical brain areas for processing noxious information. Previous studies showed that peripheral nerve injury induced broad changes in the ACC, contributing to pain hypersensitivity. The neurons in layer 3 (L3) of the ACC receive the inputs from the mediodorsal thalamus (MD) and form the feedforward inhibition (FFI) microcircuits. The effects of peripheral nerve injury on the MD-driven FFI in L3 of ACC are unknown. In our study, we record the enhanced excitatory synaptic transmissions from the MD to L3 of the ACC in mice with common peroneal nerve ligation, affecting FFI. Chemogenetically activating the MD-to-ACC projections induces pain sensitivity and place aversion in naive mice. Furthermore, chemogenetically inactivating MD-to-ACC projections decreases pain sensitivity and promotes place preference in nerve-injured mice. Our results indicate that the peripheral nerve injury changes the MD-to-ACC projections, contributing to pain hypersensitivity and aversion.

Modified pendulum osteotomy to correct severe tibial varus deformity

Correction of asevere tibial varus deformity near the knee joint with only aslight influence on leg length and patella height. Medial osteoarthritis and/or cartilage damage with asevere varus deformity > 10° with amedial proximal tibial angle (MPTA) < 80°. Femoral varus deformity with lateral distal femoral angle > 91°, severe lateral cartilage damage, lateral osteoarthritis, lateral meniscus loss. Skin incision of approx. 8-10 cm between the tibial tuberosity and the head of the fibula. Exploration of the peroneal nerve. Detachment of the extensors. Insertion of an obliquely ascending guidewire ending approximately 10 mm below the medial articular surface. Insertion of asecond guidewire. This aims at the middle of the first wire (hemi wedge). Check the wire position under fluoroscopy. Osteotomy with an oscillating saw under cooling. Removal of the wedge and closure of the osteotomy. Percutaneous needling of the medial collateral ligament with acannula to carefully lengthen the ligament. Check the correction result with ametal rod. Osteosynthesis with lateral angle-stable plate. Partial weight-bearing with 10 kg for 6weeks postoperatively, free range of motion. Reports from the literature show that good clinical results can be achieved with this procedure for severe tibial varus deformities. Postoperative leg length discrepancies are less common with this procedure than with laterally closing osteotomy.

Association of H-reflex parameters and peroneal nerve conduction velocity with dynamic balance and agility in university athletes: a cross-sectional study

Abstract Athletic performance parameters encompass a wide range of physical, physiological, and biomechanical measures that are crucial for evaluating and optimising athletes’ capabilities. There are various intrinsic factors that can contribute to athletic skills, which subsequently impact overall performance. Thus, there is a need to explore significant intrinsic factors associated with athletic parameters, that can provide insights into the physiological mechanisms underlying performance. In this study, we examined the potential relationship of two such intrinsic factors, namely the H-reflex and the peroneal nerve conduction velocity, with athletic skills like dynamic balance and agility. Forty-five university-level athletes of all genders playing for different teams of Jamia Millia Islamia University, New Delhi, India were selected. All athletes underwent tibial H-reflex, peroneal NCV, mSEBT (for dynamic balance), and agility T-test evaluations. The Pearson correlation coefficient was calculated to evaluate the association of nerve function parameters (H-reflex and NCV) with athletic performance parameters (dynamic balance and agility). Results showed that H-reflex amplitude showed a significant negative correlation with both dynamic balance scores (Dominant Leg [DL]: r = −0.321 and ; Non-dominant leg [NDL]: r = −0.397 and ) and T-test scores (DL: r = −0.342; NDL: r = −0.321, ), respectively. The peroneal NCV was significantly positively correlated with dynamic balance (DL: r = 0.438 and ; NDL: r = 0.418 and ) and agility scores (DL: r = 0.639 and ; NDL: r = 0.641 and ) in athletes. In conclusion, significant associations were found between H-reflex and Peroneal nerve conduction velocity and key athletic performance parameters like dynamic balance and agility among university athletes. This implies that neural function is closely linked with athletic skills and performance. Registered in Clinical Trials Registry-India (CTRI) under registration number: REF/2023/11/075394.

Lateral closing wedge high-tibial osteotomy is a long-lasting option for patients under the age of 55 with medial compartment osteoarthritis.

Assess the survival of the closing wedge high tibial osteotomy (CWHTO) with failure defined as progression to total knee arthroplasty (TKA) and perioperative complications. Patients undergoing CWHTO in a single centre were included in this study. The patient's demographics, operative data and patient-reported outcome measures were collected from the medical records. The outcomes assessed were progression to TKA, complications and patient-reported outcome measures. The Australian joint registry was used to assess which patients progressed to TKA. A binary logistics regression is used to determine if any of the collected factors increase the likelihood of conversion to arthroplasty. Survival analysis is conducted using a Kaplan-Meier survivorship analysis with failure defined as progression to TKA. Three hundred and fifty-four (244 males and 110 females) patients were included in the study. The average age of the group was 51 years with an average follow-up of 18 years. Patients under the age of 55 had a lower rate of progression to TKA. At 15 years, the rate of progression to TKA was 64% and 85% for those under the age of 55 and over 55, respectively. The complication rate was 6% without any peroneal nerve palsies. CWHTO is a good surgical option particularly when indicated in patients under the age of 55. Additionally, this technique results in a low overall complication rate with an absence of the often-feared complication of peroneal nerve palsy. Level III, Retrospective study.

29 - The Effect of Peroneal Nerve Stimulation on Bladder Function in a Rat Model of

29 - The Effect of Peroneal Nerve Stimulation on Bladder Function in a Rat Model of

Cost-effectiveness analysis of the geko™ device (an NMES technology) in managing venous leg ulcers in UK healthcare settings.

This study evaluates the cost-effectiveness of the geko device a neuromuscular electro-stimulator technology with standard of care (SoC) versus SoC alone for venous leg ulcer (VLU) treatment, from the UK National Health Service (NHS) perspective over 12 months. Research was conducted across NHS UK facilities, primarily within community services and outpatient leg ulcer clinics, encompassing a total of 51 patients. A partitioned survival model, based on a two-arm randomised controlled trial, assessed wound healing rates using Kaplan-Meier curves and parametric extrapolations over a 12-month time horizon. Costs were derived from UK reference costs the British National Formulary, and the Personal Social Services Research Unit (2021/22). The primary outcome measured was the incremental cost per quality-adjusted life-year gained. The geko device provides additional benefits by stimulating the lateral popliteal nerve, augmenting venous, arterial, and microvascular flow. The addition of the geko device to SoC significantly enhanced outcomes, increasing healing probability by 68% compared to SoC. This integration would result in a cost saving of £774.14 per patient when compared to the SoC alone across the NHS. Economic analyses indicate that integrating the geko device into SoC protocols would reduce the overall NHS expenditure on VLU wound management by as much as 15%. The approach also positively impacted health-related quality of life. The geko™ device when used adjunctively with SoC would be a cost-effective method for managing chronic VLUs within the NHS, improving healing rates and offering economic benefits.

Arthroscopic Debridement and Proximal Fibular Osteotomy in the management of knee Osteoarthritis: A Descriptive Longtudinal Study

Introduction: Knee osteoarthritis commonly occurs in the medial compartment. Arthroscopic debridement eases pain by irrigating debris and inflammatory cytokines. Proximal fibular osteotomy shifts the loading force more laterally from the medial compartment, eliminating pain and delaying degenerative progression. This study aims to evaluate pain relief by combining both procedures in knee osteoarthritis of the medial compartment. Methods: The study was conducted in Nepal Medical College Teaching Hospital from November 2021 to December 2022 after the ethical approval from institutional review committee (IRC Ref. No. 025-078/079). The outcome was assessed by visual analog score and knee society scores, who underwent a combined procedure of arthroscopic debridement and proximal fibular osteotomy during a study period of 12 months.Results: Diagnostic arthroscopy was done in 32 patients, out of which, 27 patients underwent combined procedure with arthroscopic debridement and proximal fibular osteotomy. The mean visual analog score in combined procedure was 6.89 ± 0.93 initially and 3.11 ± 0.69 at 12 months follow up. The mean knee society score in combined procedure was 46.85 ± 6.1 preoperatively and 84.26 ± 8.27 postoperatively at 12 months follow up. Common peroneal nerve neuropraxia was observed in 8 (29.62%) patients, which resolved spontaneously during 6 months of time period. Conclusions: Combined arthroscopic debridement and proximal fibular osteotomy procedure is effective in treating knee osteoarthritis of the medial compartment, as it decreases pain and improves knee society score.

Anterolateral and accessory anterolateral portals are safe to avoid subcutaneous nerve injury during subtalar arthroscopy-Definition of safe zones for standard lateral portals.

Injury to the superficial peroneal nerve (SPN) or the sural nerve (SN) is a common complication in subtalar arthroscopy. The purpose of this anatomical study was to evaluate the distance to surrounding subcutaneous nerves in the vicinity of three standard arthroscopic portals for subtalar joint arthroscopy and through actual portal placement for arthroscopic procedures, in order to define anatomical safe zones. Forty paired fresh-frozen foot-and-ankle specimens were used. Subtalar arthroscopy using a three-portal technique (anterolateral [AL], posterolateral [PL] and accessory anterolateral [AAL] portals) was performed. After completion of subtalar arthroscopy, the portals were marked, and all surrounding subcutaneous nerves, that is, the branches of the SPN and SN, were dissected. The distance of the nearest nerve at the level of the respective portal was measured and potential injury was recorded. The nearest nerve at the level of the AL portal was the intermediate dorsal cutaneous nerve at a mean of 15.4 ± 5.1 mm medial to the portal. The nearest nerve at the level of the AAL portal was the lateral dorsal cutaneous nerve at a mean of 17.7 ± 4.8 mm, being lateral to the portal. The nearest nerve at the level of the PL portal was the SN at a mean of 6.7 ± 4.7 mm anterior to the portal. Based on the measurements, safe zones were defined. Placement of the AL and AAL portals in subtalar arthroscopy is saved using standard anatomical landmarks and a thorough surgical technique. At the level of the PL portal, the SN is the most endangered structure in subtalar arthroscopy. Surgeons should be aware of the proximity of the SN to the PL portal and take the utmost care during portal placement and instrument insertion to avoid iatrogenic injury. The risk of nerve damage during portal placement may be reduced when positioning the portals in the defined safe zones. Not applicable.

Some Characteristics of Peripheral Neuropathy in Newly Diagnosed Type 2 Diabetes Patients

Objectives: To describe the clinical and electrophysiological characteristics of peripheral nerve damage in newly diagnosed type 2 diabetes patients. Subjects and methods: A cross-sectional descriptive study was conducted on 101 people with newly diagnosed type 2 diabetes patients at the Department of Endocrinology - Diabetes and Neurology Center of Bach Mai Hospital. Results: The average age of the patients is 58.04 ± 12.66 years; males account for 60.4%, while females account for 39.6% (p = 0.038). The majority of patients have HbA1C levels ≥ 7%, accounting for 86.1%. The average HbA1C level is 11.6%. There is a correlation between age and abnormalities in electromyography of the median nerve, ulnar nerve, sural nerve, peroneal nerve and tibial nerve. There is a correlation between HbA1C levels and abnormalities in electromyography of the superficial peroneal nerve, median nerve, ulnar nerve, and peroneal nerve (p &lt; 0.05). Conclusion: Nerve conduction studies can reveal early changes in peripheral nerve damage in patients with newly diagnosed diabetes.

Acute normobaric hypoxia causes a rightward shift in the torque-frequency relationship, but has no effect on post-activation potentiation

Low fractions of inspired oxygen (FIO2; i.e., hypoxia) affect aspects of skeletal muscle contractility in humans, but it remains unclear if post-activation potentiation (PAP) and the torque-frequency (T-F) relationship are altered. We investigated the effects of two (H2) and four hours (H4) of normobaric hypoxia (FIO2=0.11±0.47) on the magnitude of PAP of the knee extensors (KE) and the T-F relationship of the dorsiflexors (DF) in 13 and 12 healthy participants, respectively. To assess PAP, a resting twitch was evoked via femoral nerve stimulation before, and 2-300 s following a 10-s maximal voluntary contraction (MVC). A T-F relationship was obtained by stimulating the common fibular nerve with a single pulse and 1-s trains between 5-100 Hz. During hypoxia, peripheral oxygen saturation decreased by ~18% from 98.0±0.8% at baseline (P&lt;0.001). MVC force and voluntary activation (VA) of the KE were lower than baseline throughout hypoxia (e.g., ~8 and ~5%, respectively at H2; P≤0.027); however, the magnitude of PAP was not altered by hypoxia (P≥0.711). Surprisingly, PAP did increase with time across the control day (P≤0.012). MVC torque and VA of the DF were unaffected by hypoxia (P≥0.127), but the estimated frequency required to evoke 50 % of 100-Hz torque increased by ~1.2 Hz at H2 (P≤0.021). These results imply that two hours of normobaric hypoxia were sufficient to: i) impair neural drive to the KE but not the mechanism(s) responsible for PAP, and ii) lead to a rightward shift of the T-F relationship for the DF.

Stem Cells Rehabilitate Diabetic Neuropathy

To report the effectiveness of stem cell treatment in diabetic neuropathy. This study recruited 83 Iraqi females from 45 to 73 years old who had NIDDM between August 31, 2020 and June 30, 2023. All of them had a "Diabetic neuropathy symptom score (DNS)" (grade 3–4) and a "Diabetic foot sensory neuropathy score" (grade 1-2). They all had HbA1c (10-13%) from 7 to 10 years. The patient/family provided informed permission when they visited the "Al Zahrawy Center for Stem Cells in Baghdad". For four treatment sessions (once every three weeks), Hamad dispersed stem cells around the tibial and deep peroneal nerves. Among 83 Iraqi females, 49 (59.1%) had a grade 4 "Diabetic neuropathy symptom score" upon presentation, which decreased to 24.2% in 20 females after three months of medication. Their "Diabetic foot sensory neuropathy (DNS)" was (54.3%) in 45 females at presentation and decreased to (21.8%) in 18 females after three months of treatment. The satisfaction rate for therapy was 74.6% for the "Diabetic neuropathy symptom score" and 78.3% for "Diabetic foot sensory neuropathy (DNS)". Stem cell therapy is a good treatment option for diabetic neuropathy. The researchers supported it and suggested a greater sample size in other places.

Comparison of the Analgesic Duration Using Ultrasound-guided Popliteal Sciatic Nerve Block between Diabetics with Neuropathy and Nondiabetics without Neuropathy.

In India, the prevalence of diabetes mellitus neuropathy was reported to be as high as 30%. Eight percentage of the diabetic population suffer from foot ulceration and 1.8% have amputations. Popliteal nerve block can be potentially used for foot and ankle surgery with several advantages. To compare analgesic duration of an ultrasound (US)-guided popliteal sciatic nerve block between diabetics with neuropathy and nondiabetics without neuropathy. Participants were allocated into two groups for popliteal sciatic nerve blocks under US guidance. The primary outcome was the duration to onset of sensory and motor blockade. The secondary outcome was the duration to rescue analgesic and the visual analog scale scoring within 24 h. Hemodynamic outcomes were also monitored along with the above variables. It was observed that the onset of sensory blockade was faster in participants with diabetes mellitus with peripheral neuropathy as compared to the nondiabetic participants and the duration for onset of motor blockade in dorsiflexion was faster in diabetic patients as compared to the nondiabetic patients (17.48 ± 3.21 min). However, there was no significant changes when comparing the onset of duration to loss of plantar flexion, in diabetics (17.86 ± 2.29 min) versus in nondiabetics (18.51 ± 3.32 min). The duration for rescue analgesics was found to be longer in diabetic participants (13.19 ± 2.14 h) as compared to the nondiabetic participants (11.44 ± 1.86 h). No differences were observed in the hemodynamic changes and the complications associated with local anesthetics in either group. Diabetic patients with neuropathy have faster onset of blockade when compared to nondiabetic patients without neuropathy which may be due to the degenerative condition of the peripheral nerves in them. The hemodynamic parameters do not play a role in defining the outcome of the block.

Using Electrical Muscle Stimulation to Enhance Electrophysiological Performance of Agonist-Antagonist Myoneural Interface.

The agonist-antagonist myoneural interface (AMI), a surgical method to reinnervate physiologically-relevant proprioceptive feedback for control of limb prostheses, has demonstrated the ability to provide natural afferent sensations for limb amputees when actuating their prostheses. Following AMI surgery, one potential challenge is atrophy of the disused muscles, which would weaken the reinnervation efficacy of AMI. It is well known that electrical muscle stimulus (EMS) can reduce muscle atrophy. In this study, we conducted an animal investigation to explore whether the EMS can significantly improve the electrophysiological performance of AMI. AMI surgery was performed in 14 rats, in which the distal tendons of bilateral solei donors were connected and positioned on the surface of the left biceps femoris. Subsequently, the left tibial nerve and the common peroneus nerve were sutured onto the ends of the connected donor solei. Two stimulation electrodes were affixed onto the ends of the donor solei for EMS delivery. The AMI rats were randomly divided into two groups. One group received the EMS treatment (designated as EMS_on) regularly for eight weeks and another received no EMS (designated as EMS_off). Two physiological parameters, nerve conduction velocity (NCV) and motor unit number, were derived from the electrically evoked compound action potential (CAP) signals to assess the electrophysiological performance of AMI. Our experimental results demonstrated that the reinnervated muscles of the EMS_on group generated higher CAP signals in comparison to the EMS_off group. Both NCV and motor unit number were significantly elevated in the EMS_on group. Moreover, the EMS_on group displayed statistically higher CAP signals on the indirectly activated proprioceptive afferents than the EMS_off group. These findings suggested that EMS treatment would be promising in enhancing the electrophysiological performance and facilitating the reinnervation process of AMI.

Efficacy and safety of hyperbaric oxygen therapy for diabetes peripheral neuropathy: A systematic review and meta-analysis.

Diabetes peripheral neuropathy (DPN) is mainly treated with diabetes as a whole, and there is no targeted treatment. Some studies have reported that adjuvant hyperbaric oxygen therapy (HBOT) for DPN has achieved a good effect, our study aimed to evaluate the clinical efficacy and safety of HBOT for DPN and provide reference for the clinic by using a systematic review and meta-analysis. A comprehensive search was conducted across several databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Internet Database, Chinese BioMedical Database, China Scientific Journal Database, and Wanfang Database, for relevant randomized controlled trials published before July 2022. The population, intervention, comparison, outcomes, study design criteria were used to guide the selection of studies. Meta-analysis was performed using RevMan 5.4 and STATA 14.0, with odds ratios and mean differences along with 95% confidence intervals serving as measures of effect size. Fourteen randomized controlled trials were included in the final analysis, comprising 675 patients in the HBOT group and 648 in the standard therapy (ST) group. The HBOT group demonstrated a significantly higher effective treatment rate compared to the ST group (P < .001). Additionally, the HBOT group showed significant improvements in motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNVC) across multiple nerves: median nerve (PMNCV < 0.001, PSNCV = 0.001), ulnar nerve (PMNCV = 0.02, PSNCV < 0.001), peroneal nerve (PMNCV < 0.001, PSNCV < 0.001), and tibial nerve (PMNCV = 0.001, PSNCV = 0.008). Six adverse events were reported in the HBOT group, while no adverse events occurred in the ST group, with no significant difference between the 2 groups. Publication bias was identified in some outcome variables through funnel plots, Begger test, and Egger test. HBOT significantly enhances treatment efficacy and nerve conduction velocity in patients with DPN, with few adverse events, making it a safe and effective adjunctive therapy for DPN.