Long-term evaluation of interdigital neuroma treated by surgical excision.
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Womack JW, Richardson DR, Murphy GA, Richardson EG, Ishikawa SN.
Foot Ankle Int. 2008 Jun;29(6):574-7.
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Neurectomy versus neurolysis for Morton's neuroma.
Villas C, Florez B, Alfonso M.
Foot Ankle Int. 2008 Jun;29(6):578-80.
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"second webspace had worse outcomes than third webspace neuromas ..."
Think maybe incorrect preoperative Diagnosis?
I have not seen THAT many 2nd interspace neuromas over the years, but have seen quite a few failed 2nd interspace neuromas resections!!!!
Coincidence? Maybe.
My knee jerk response would be that a certain percentage of 2nd Interspace neuromas are done NOT on neuroma patients but on patients with 2nd MTPJ pathology or even non classic Tarsal Tunnel syndromes.
Steve -
I agree with Dr. Arbes. We are fortunate to have an excellent radiology dept. at our hospital with high end diagnostic ultrasound equipment and those experienced to read it. They frequently find an intermetatarsal bursa with no neuroma. We have them inject it under US guidance when found. They feel to the patient just like a neuroma. We also find that the US is very good at finding neuromas but not nearly as good at finding inflammatory joint changes. MRI does that better. We recently had a patient seen elsewhere and diagnosed with a 2nd space neuroma that was injected with only brief relief. An MRI showed inflammatory changes in the surrounding soft tissue and MTP joint effusion. He had only mild psoriasis but appears to have been experiencing the first signs of psoriatic arthritis. 2nd MTP joint predislocation syndrome is often misdiagnosed as a 2nd space neuroma.
I don't recall who said it first but, "The wrong operation, perfectly executed is doomed before the first incision is made." -
One more thing:
"BACKGROUND: We examined a large cohort of patients who had interdigital neurectomy and evaluated their clinical outcomes by using a previously developed scoring system as well as a visual analog scale (VAS). In addition, we wanted to identify risk factors that may lead to poorer outcomes. "
COHORT? Think they could have used a different description, perhaps sampling, population, group, "number", anything.
LARGE COHORT? I picture a large group of ex military men limping around the mall!
Steve -
The outcome of Morton's neurectomy in the treatment of metatarsalgia.
Pace A, Scammell B, Dhar S.
Int Orthop. 2009 May 30. [Epub ahead of print]
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Results of operative treatment of double Morton's neuroma in the same foot.
Lee KT, Lee YK, Young KW, Kim HJ, Park SY.
J Orthop Sci. 2009 Sep;14(5):574-8. Epub 2009 Oct 3.
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The outcome after using two different approaches for excision of Morton's neuroma.
Faraj AA, Hosur A.
Chin Med J (Engl). 2010 Aug;123(16):2195-2198.
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Hi Steve
I'm interested. Is not "cohort" the standard descriptor for a sampled population in such a study in the US.A.?
All the best
Bill -
Long-Term Results of Neurectomy in the Treatment of Morton's Neuroma: More Than 10 Years' Follow-up
Kyung Tai Lee et al
Foot Ankle Spec December 1, 2011
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13 patients?
This is too small of a sample to have a study.
This is a study of patients over a two year period. If you can't come up with more than 13 patients for your study then you shouldn't be performing a study.
5 patients were satisfied with major reservations.
What the heck does that mean.
I hope my tax dollars didn't help pay for this.
Steve -
Last week I saw a 62 year old man that I performed a left 3rd intermetatarsal neurectomy on over 25 years ago. He hasn't had pain in this area of his foot since the surgery and thought he thought it was a great surgery for him. Good to see these people after all these years to know that I must have been doing something right during that first year of practice.;)
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When only half of the cohort send back the questionnaire that tells you something.
Patients who are unhappy are something like 8 times as likely to respond.
Cheers -
Surgical treatment of Morton's neuroma: clinical results after open excision.
Kasparek M, Schneider W.
Int Orthop. 2013 Jul 13.
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Metatarsal Shortening Osteotomy for Decompression of Morton’s Neuroma
Eui Hyun Park, Yong Sang Kim, Ho Jin Lee, Yong Gon Koh
Foot & Ankle International July 26, 2013 1071100713499905
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Dumb x 1 - List
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Minimally invasive endoscopic decompression of the intermatatarsal nerve for Morton's neuroma
Mitsuaki Kubota et al
Journal of Orthopaedics; Available online 31 January 2014
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Morton’s neuroma neuro-osteodesis through a plantar approach
Ahmed Shams, Mohamed M. H. El-Sayed
European Orthopaedics and Traumatology; July 2014
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Description of Total Population Hospital Admissions for Morton's Metatarsalgia in Australia
Reza Naraghi, DPM, Alan Bryant, PhD, and Linda Slack-Smith, PhD
Journal of the American Podiatric Medical Association: September 2014, Vol. 104, No. 5, pp. 451-454.
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Metatarsalgia and Morton's Disease: Comparison of Outcomes Between Open Procedure and Neurectomy Versus Percutaneous Metatarsal Osteotomies and Ligament Release With a Minimum of 2 Years of Follow-Up
Thomas Bauer, MD, Elodie Gaumetou, MD, Shahnaz Klouche, MD, Philippe Hardy, MD, PhD, Nicola Maffulli, MD, PhD
The Journal of Foot and Ankle Surgery; Articles in Press
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Our experience in the surgical treatment of Morton’s metatarsalgia with a minimally invasive surgery technique
O. Catani, G. Corrado, F. Sergio, M. Zappia, A. D’Apice
Médecine et Chirurgie du Pied; February 2015
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Corrective Osteotomy of Metatarsal Bone for Surgical Treatment of Morton’s Neuroma
Intak Chu, Hoseong Jang, Hyun-Woo Park
J Korean Foot Ankle Soc. 2015;19:58-62
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Does anyone have any recent research on the difference between a dorsal or plantar incision?
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Simple Neurectomy Versus Neurectomy With Intramuscular Implantation for Interdigital Neuroma
A Comparative Study
Chamnanni Rungprai et al
Foot & Ankle International August 21, 2015
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Transection of the deep metatarsal transverse ligament in Morton’s neuroma surgery does not increase risk of splayfoot development
Maximilian Kasparek , Wolfgang Schneider
International Orthopaedics; 07 September 2015
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OUTCOMES FOLLOWING SURGICAL EXCISION OF INTERDIGITAL MORTON'S NEUROMA: A PROSPECTIVE STUDY
V. Bucknall, D. Rutherford, D. Macdonald, H. Shalaby, J. McKinley and S. Breusch
Bone Joint J 2015 vol. 97-B no. SUPP 14 27
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Endoscopic Intermetatarsal Ligament Decompression
Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S
Arthroscopy Techniques; Article in Press
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Excision With Interpositional Nerve Grafting: An Alternative Technique for the Treatment of Morton Neuroma.
Ratanshi, Imran MD, MSc; Hayakawa, Thomas E.J. MD; Giuffre, Jennifer L. MD
Annals of Plastic Surgery: January 21, 2016
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Successful Treatment of Foot and Ankle Neuroma Pain With Processed Nerve Allografts
Jason M. Souza et al
Foot & Ankle International June 23, 2016 1071100716655348
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Outcomes following excision of Morton’s interdigital neuroma
a prospective study
V. Bucknall, D. Rutherford, D. MacDonald, H. Shalaby, J. McKinley, S. J. Breusch
Bone Joint J 2016;98-B:1376–81.
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Endoscopic Interdigital Neurectomy of the Foot
Tun Hing Lui
Endoscopy; Article in Press
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Deep Transverse Metatarsal Ligament Transection in Morton's Neuroma Excision A Cadaveric Study Examining Effects on Metatarsal Alignment.
Preston N et al
Foot Ankle Spec. 2017 Oct 1:1938640017735888. doi: 10.1177/1938640017735888.
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Morton's neuroma (interdigital neuralgia) treated with metatarsal sliding osteotomy
Joonho Lee et al
Year : 2017 | Volume : 51 | Issue : 6 | Page : 692-696
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Friendly x 1 - List
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PATIENT FACTORS AFFECTING OUTCOME FOLLOWING MORTON'S NEUROMA EXCISION: A PROSPECTIVE STUDY
V. Bucknall, D. Rutherford, D. Macdonald, H. Shalaby, J. McKinley, S.J. Breusch
Orthopaedic Proceedings 20 November 2017
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Surgical interventions for the treatment of painful neuroma: a comparative meta-analysis
Poppler, Louis H. MD, MSCI; Parikh, Rajiv P. MD, MPHS; Bichanich, Miles J. BS; Rebehn, Kelsey MD; Bettlach, Carrie R. MSN, FNP; Mackinnon, Susan E. MD; Moore, Amy M. MD
PAIN: November 20, 2017
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Morton's Neuroma (Interdigital Neuralgia) Treated with Metatarsal Sliding Osteotomy.
Lee J et al
Indian J Orthop. 2017 Nov-Dec;51(6):692-696. doi: 10.4103/0019-5413.217678.
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Assessment of pain, function and complications after minimelly invasive decompression of morton´s neuroma using a dorsal approach in 16 patients
Sancho-Barroso F et al
Acta Ortop Mex. 2017 May-Jun;31(3):113-117.
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Morton's Neuroma Excision: What Are We Really Doing? Which Retractor Is Superior?
Pinter Z et al
Foot Ankle Spec. 2018 Aug 15:1938640018790013.
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Isolated Intermetatarsal Ligament Release as Primary Surgical Management for Morton’s Neuroma:
the Carpal Tunnel of the Foot?
Mohamed Abdelaziz, MD, Kathryn Whitelaw, Gregory Waryasz, MD, Daniel Guss, MD, MBA, Anne Johnson, MD, Christopher
DiGiovanni, MD
AOFAS Annual Meeting 2018 1
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