Outcomes following excision of Morton’s interdigital neuroma

Bucknall, V.; Rutherford, D.; MacDonald, Deborah J.; Shalaby, H.; McKinley, John; Breusch, S. J.

doi:10.1302/0301-620x.98b10.37610

Cited by 42 publications

(29 citation statements)

References 23 publications

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“…11,32 Nevertheless, other reports did not confirm this hypothesis. 6,9 In this study, 6 patients presented with 2 neuromas in different spaces of the same foot but showed the same favorable outcomes as patients with 1 isolated neuroma, with only more sensory loss without pain observed.…”

Section: Discussionsupporting

confidence: 60%

Interdigital Commissural Approach for Morton’s Neuroma

Arauz

2020

Foot Ankle Int.

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Background: Morton’s neuroma is a frequent cause of metatarsalgia. Operative treatment is indicated if nonoperative management has failed. The objective of the present study was to describe a technique of Morton’s neuroma excision by a minimally invasive commissural approach and evaluate the long-term outcome and complications. Methods: A retrospective study of 108 patients with Morton’s neuroma treated surgically with a commissural approach between September 1990 and December 2010 was performed. The surgical technique is described. Clinical outcomes and complications were evaluated. The average follow-up was 121 months. Eleven patients were men and 97 women. The average age was 49.4 years; 56.8% neuromas were at the third space and 43.2% at the second space. Six patients presented 2 neuromas in the same foot, and 9 patients had bilateral neuroma. Results: The visual analog scale (VAS) average pain score was 5.4 points preoperatively and 0.2 points at the final follow-up. The author found a significant difference between the VAS scores preoperatively and postoperatively ( P < .01). Excellent and good satisfaction outcomes were achieved in 93.6%. The postoperative complication incidence was 3%. Conclusion: The author believes a minimally invasive commissural approach has advantages over a dorsal or plantar incision. It is a simple and reproducible technique, with satisfactory outcomes, low complication rates, and a quick return to usual activities. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionsupporting

confidence: 60%

Interdigital Commissural Approach for Morton’s Neuroma

Arauz

2020

Foot Ankle Int.

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“…19–21 Interestingly, and quite consistently, only about half of the patients report no pain after surgery, whereas approximately 30% are better than preoperatively but with residual pain, and one in ten is worse than before the surgery. 19–21 One study showed similar results between neurectomy and neurectomy combined with intramuscular implantation of the nerve stump. 22 The procedure can be performed either through a dorsal or plantar approach, depending on the surgeon’s training and preference.…”

Section: Operative Management: Techniques and Outcomesmentioning

confidence: 94%

“…Revision surgery can be complicated 26,27 and patient outcomes can be even worse compared to those after the primary exploration and neurectomy. 21 The term ‘recurrent neuroma’ is probably misleading. The ongoing pain may be a result of nerve stump irritation (e.g.…”

Section: Operative Management: Techniques and Outcomesmentioning

confidence: 99%

Morton’s interdigital neuroma: instructional review

2019

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The terminology ‘Morton’s neuroma’ may represent a simplification of the clinical condition as the problem may not be a benign tumour of the nerve, but neuropathic foot pain associated with the interdigital nerve.Foot and ankle pathomechanics leading to metatarsalgia, clinical examination and differential diagnosis of the condition and imaging of the condition, for differential diagnosis, are discussed.Nonoperative management is recommended initially. Physiotherapy, injections (local anaesthetic, steroid, alcohol), cryotherapy, radiofrequency ablation and shockwave therapy are discussed.Operative treatment is indicated after nonoperative management has failed. Neuroma excision has been reported to have good to excellent results in 80% of patients, but gastrocnemius release and osteotomies should be considered so as to address concomitant problems.Key factors in the success of surgery are correct diagnosis with recognition of all elements of the problem and optimal surgical technique.Cite this article: EFORT Open Rev 2019;4:14-24. DOI: 10.1302/2058-5241.4.180025.

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“…[82][83][84][85] Surgical excision yields a good to excellent outcome in more than 70% of reported cases. 86,87 Lateral Femoral Cutaneous Nerve…”

Section: Treatmentmentioning

confidence: 99%

Common Entrapment Neuropathies

Malek

Salameh

2019

Semin Neurol

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Entrapment neuropathies are defined as compression of peripheral nerves due to known or unknown causes. The high incidence and variety of presentations require a comprehensive knowledge of these conditions, especially in neurology and orthopedic surgery clinical practices. Detailed knowledge of topographic anatomy, clinical manifestations, and appropriate use of electrophysiological studies with selective addition of neuromuscular ultrasonography are needed to establish an early and accurate diagnosis to advice patients and provide them with a comprehensive treatment plan. In this article, we discuss the most common forms of entrapment neuropathies in the upper and lower extremities.

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Outcomes following excision of Morton’s interdigital neuroma

Cited by 42 publications

References 23 publications

Interdigital Commissural Approach for Morton’s Neuroma

Interdigital Commissural Approach for Morton’s Neuroma

Morton’s interdigital neuroma: instructional review

Common Entrapment Neuropathies

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