Long-term evaluation of interdigital neuroma treated by surgical excision.
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.


METHODS
A retrospective review identified 232 patients who had neuroma excision between 1994 and 2004, after failure of conservative treatment. Each patient was contacted via mail and given a Neuroma Clinical Evaluation Score survey as well as a visual analog score. Each patient received a unique identification number, allowing the evaluation process to be single-blinded.


RESULTS
Of the 232 patients contacted, 120 (52%) returned their completed surveys. The average Giannini neuroma score was 53: 61 feet (51%) had good or excellent results, 12 (10%) had fair results, and 48 (40%) had poor results. The average VAS score was 2.5. The only significant (p = 0.027) difference in outcome was the location of the neuroma: second webspace had worse outcomes than third webspace neuromas on both the VAS and neuroma score.


CONCLUSIONS
This retrospective review identified location in the second webspace as a possible prognostic indicator of poor outcome, but the more important finding may be that outcomes of neuroma excision do not appear to be as successful at long-term followup as previously reported.
Univ. of Tennessee - Campbell Clinic, Orthopaedic Surgery, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA.
John W
JW
Womack
David R
DR
Richardson
G Andrew
GA
Murphy
E Greer
EG
Richardson
Susan N
SN
Ishikawa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005534:Foot Diseases / Q000473:pathology / Q000601:surgery*; D005545:Forefoot, Human; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009463:Neuroma / Q000473:pathology / Q000601:surgery*; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D012775:Shoes; D013997:Time Factors; D016896:Treatment Outcome