title: Plantar approach for Morton's neuroma: An effective technique for primary excision.
abstract: BACKGROUND
  Morton's neuroma is a common cause of inter-metatarsal foot pain. Surgical excision is generally indicated when non-operative measures have been unsuccessful; various surgical techniques have been described in the literature for excision, with no consensus on the overall ideal surgical approach.
  
  
  OBJECTIVE
  To assess patient outcomes and complications following plantar surgical approach to neurectomy in a consecutive series of patients.
  
  
  METHODS
  An analysis of consecutive patients undergoing excision of Morton's neuroma using a plantar approach by a single surgeon over a 12 month period. Pre- and post-operative AOFAS and VAS scores were completed during outpatient visits.
  
  
  RESULTS
  20 patients were included in the study, with pre-operative confirmation of a soft tissue mass on ultrasound scan. All patients demonstrated improvement in their post-operative functional scores; 2 patients (10%) did not have full resolution of their symptoms post-operatively. Mean AOFAS scores improved from 39 to 80 post-operatively and VAS from 40 to 92. No patients had wound complications or scar pain.
  
  
  CONCLUSIONS
  Neurectomy performed via a plantar approach provides good exposure, adequate soft tissue healing, with rapid resolution of pain and return to normal activities post-operatively.
authors.affiliation: Orthopaedic Department, University Hospital of North Tees, Hardwick Road, Stockton-on-Tees TS19 8PE, United Kingdom. Electronic address: maire-clare.killen@doctors.org.uk.
authors.forename: Maire-Clare
authors.initials: MC
authors.lastname: Killen
authors.affiliation: Orthopaedic Department, University Hospital of North Tees, Hardwick Road, Stockton-on-Tees TS19 8PE, United Kingdom.
authors.forename: Prasad
authors.initials: P
authors.lastname: Karpe
authors.affiliation: Orthopaedic Department, University Hospital of North Tees, Hardwick Road, Stockton-on-Tees TS19 8PE, United Kingdom.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Limaye
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005534:Foot Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D037061:Metatarsalgia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D009463:Neuroma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Inter-metatarsal; Neurectomy; Neuroma; Plantar approach