Abstract
Background
Morton’s neuroma is an entrapment neuropathy. Several surgical techniques were proposed for the management of this painful condition and to potentially limit the stump neuroma formation with variable results including attempts to seal the end of the nerve with cryogenic freezing, cauterization, electrocoagulation, carbon dioxide laser, chemical sclerosis, mechanical crush or ligation, fascial capping, and synthetic capping with methyl methacrylate, cellophane, collodion, silicone, glass, tin, tantalum, and silver and gold foils.
Patients & Methods
In this study, 18 patients with Morton’s metatarsalgia were treated using a plantar approach, and neuro-osteodesis that entails burring the nerve into adjacent bone.
Results
All patients had satisfactory results except one case that necessitated a second surgery. Twelve patients were completely satisfied and five were satisfied with minor reservations.
Conclusions
Based on the results provided by this prospective study, we believe that neuro-osteodesis through a plantar approach is expected to be a satisfactory measure for the management of this painful foot condition.
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References
Aronow MS (2009) Morton’s neuroma excision with neuromyodesis burying of the proximal nerve stump into the interosseus muscle via a single dorsal incision. Tech Foot Ankle Surg 8(1):38–42
Wolfort SF, Dellon AL (2001) Treatment of recurrent neuroma of the interdigital nerve by implantation of the proximal nerve into muscle in the arch of the foot. J Foot Ankle Surg 40(6):404–410
Stamatis ED, Myerson MS (2004) Lower limb treatment of recurrence of symptoms after excision of an interdigital neuroma a retrospective review. J Bone Joint Surg (Br) 86B:48–53
Greenfield J, Rea J, Ilfeld FW (1984) Morton’s interdigital neuroma. Indications for treatment by local injections versus surgery. Clin Orthop Relat Res 185:142–144
Coughlin MJ, Pinsonneault T (2001) Operative treatment of interdigital neuroma. A long-term follow-up study. J Bone Joint Surg Am 83-A(9):1321–1328
Schon LC MR (2007) Diseases of the nerves. In: MJ C, Mann RA, Saltzman CL E (eds) Surgery of the foot and ankle. Philadelphia, Mosby Elsevier, p 613–685
Beskin JLBD (1988) Recurrent pain following interdigital neurectomy: a plantar approach. Foot Ankle 9:34–39
Johnson JE, Johnson KA, Unni KK (1988) Persistent pain after excision of an interdigital neuroma. Results of reoperation. J Bone Joint Surg Am 70(5):651–657
Dellon A (1989) Treatment of recurrent metatarsalgia by neuroma resection and muscle implantation: case report and proposed algorithm of management for Morton’s neuroma. Microsurgery 10:256–259
Colgrove RC, Huang EY, Barth AHGM (2000) Interdigital neuroma: intermuscular neuroma transposition compared with resection. Foot Ankle Int 21:206–211
Akermark C, Saartok T, Zuber Z (2008) A prospective 2-year follow-up study of plantar incisions in the treatment of primary intermetatarsal neuromas (Morton’s neuroma). Foot Ankle Surg 14(2):67–73
Wilson SKG (1995) Retrospective study of the use of a plantar transverse incision versus a dorsal incision for excision of neuroma. J Foot Ankle Surg 34:537–540
Nery C, Raduan F, Del Buono A, Asaumi ID, Maffulli N (2012) Plantar approach for excision of a Morton neuroma. J Bone Joint Surg Am 94(7):654–658
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Shams, A., El-Sayed, M.M.H. Morton’s neuroma neuro-osteodesis through a plantar approach. Eur Orthop Traumatol 5, 349–353 (2014). https://doi.org/10.1007/s12570-014-0262-2
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DOI: https://doi.org/10.1007/s12570-014-0262-2