Isolated Intermetatarsal Ligament Release as Primary Operative Management for Morton's Neuroma: Short-term Results.

Abstract

BACKGROUND:

Although the precise pathoetiology of Morton's neuroma remains unclear, chronic nerve entrapment from the overlying intermetatarsal ligament (IML) may play a role. Traditional operative management entails neuroma excision but risks unpredictable formation of stump neuroma.

MATERIALS AND METHODS:

Medical records were examined for adult patients who failed at least 3 months of conservative treatment for symptomatic and recalcitrant Morton's neuroma and who then underwent isolated IML decompression without neuroma resection.

RESULTS:

A total of 12 patients underwent isolated IML decompression for Morton's neuroma with an average follow-up of 13.5 months. Visual Analog Pain Scale averaged 6.4 ± 1.8 (4-9) preoperatively and decreased to an average of 2 ± 2.1 (0-7) at final follow-up (P = .002). All patients reported significant improvement.

CONCLUSION:

Isolated IML release of chronically symptomatic Morton's neuroma shows promising short-term results regarding pain relief, with no demonstrated risk of recurrent neuroma formation, permanent numbness, or postoperative symptom exacerbation.

LEVEL OF EVIDENCE:

Level IV: Case series.

• Authors: Mohamed Abdelaziz Elghazy, Kathryn C Whitelaw, Gregory R Waryasz, Daniel Guss, Anne H Johnson, Christopher W DiGiovanni
• Journal: Foot & ankle specialist (Foot Ankle Spec) Vol. 15 Issue 4 Pg. 338-345 (Aug 2022) ISSN: 1938-7636 [Electronic] United States
• PMID: 32954808 (Publication Type: Journal Article)

Topics

• Adult
• Foot
• Humans
• Ligaments, Articular (surgery)
• Morton Neuroma (surgery)
• Neuroma (surgery)
• Retrospective Studies