Neurectomy versus neurolysis for Morton's neuroma.
BACKGROUND
We evaluated a series of patients who underwent neurectomy or neurolysis for the surgical treatment of Morton's neuroma.


METHODS
A group of 50 patients (69 feet) who underwent surgery for a symptomatic Morton's neuroma were retrospectively reviewed. Surgery was performed through a dorsal approach in all cases. When the nerve showed macroscopic thickening or the typical pseudoneuroma, it was resected; when the nerve had no macroscopic changes, the intermetatarsal ligament and any other potentially compressive structure were released. In 17 cases, adjacent claw toes were treated.


RESULTS
Nerve thickening (pseudoneuroma) were resected in 46 cases; in the other 23 cases, the nerve was preserved. Total relief from digital nerve related symptoms was obtained in all cases but one in each group. These patients were reoperated on 6 months later by performing a neurectomy in the case where the nerve had been preserved, and a more proximal resection in the case in which the nerve had been resected. Both patients finally achieved complete pain relief.


CONCLUSIONS
When treating Morton's neuromas surgically, neurolysis can be a valid option when a pseudoneuroma has not developed.
Department of Orthopaedic Surgery and Traumatology, Clínica Universitaria de Navarra, Avda Pio XII 36, 31080 Pamplona Navarra Spain. cvillas@unav.es
Carlos
C
Villas
Borja
B
Florez
Matias
M
Alfonso
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005534:Foot Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005545:Forefoot, Human; D006801:Humans; D008297:Male; D008875:Middle Aged; D009463:Neuroma / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019635:Neurosurgical Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome