Morton's Interdigital Neuroma: A Comprehensive Treatment Protocol

Abstract

One hundred fifteen patients with signs and symptoms of Mortons' interdigital neuroma were studied in an attempt to evaluate the efficacy of a staged treatment program. The first stage consisted of patient education, footwear modifications, and metatarsal head relief. The second stage consisted of a steroid/local anesthetic injection into the affected interspace. The third stage was surgical excision of the inflamed interdigital nerve. Overall, 97 of 115 patients (85%) believed that they had improved with the treatment program. Twenty-four patients (21%) eventually required surgical excision of the nerve and 23 of 24 patients (96%) had satisfactory results. The results of the staged treatment protocol were very satisfactory and patient satisfaction was high.

Calcineurin-inhibitor induced pain syndrome (CIPS): a severe disabling complication after organ transplantation

“…The diagnosis of gout is supported by repeated arthritis attacks on the metacarpophalangeal joint of the first toe or other small joints with calor, rubor, dolor, and swelling in combination with elevated uric acid levels and inflammatory parameters [l5]. The pain induced by Morton's neuralgia is localised between the distal metatarsal bones 3 and 4 or 4 and 5, can be provoked by compression of the heads of these bones, and neurological investigation shows a loss of sensibility of the interdigital nerve [2]. Peripheral atherosclerosis [19] can also mimic weight dependent foot pain of CIPS, but can be excluded by angiography.…”

Neuropeptide- and tyrosine hydroxylase-immunoreactive nerve fibers in painful Morton's neuromas

“…1,3 The transverse intermetatarsal ligament is regarded by most authors as the primary cause of mechanical injury to the nerve, but compression by the metatarsal heads or a synovial cyst has also been mentioned as a causative or contributing factor. 6,23 A strong association exists between MN and rheumatoid arthritis, and it has been proposed that an inflamed or swollen intermetatarsal bursa, due to rheumatoid arthritis or some other inflammatory state, compresses or irritates the nerve.…”

Surgical treatment of Morton's neuroma: clinical results after open excision

“…The aetiology and treatment still are matter of controversy. Today, the pathomechanic principle is seen as entrapment neuropathy due to compression by the deep transverse ligament [4][5][6][7]. Histologically, the nerve is characterised by fibrosis of the soft tissue and demyelination and endoneural fibrosis of the nerve [6,8,9].…”