Dorsal approach for excision of Morton’s interdigital neuroma: A mid-term follow-up study

Abstract

Aim: Morton’s neuroma is a paroxysmal neuralgia of forefoot and when nonsurgical treatment is unsuccessful, neuroma excision is indicated. The purpose of the present study was to evaluate the outcomes, complications and existing symptoms following an excision of the neuroma using dorsal approach.Methods: The study evaluated 27 patients (21 women) with an average age of 49 years (range, 24-74) and an average follow-up of 52 months (range, 24-96). The clinical diagnosis was confirmed by history and clinical evaluation. Clinical outcomes were assessed using the interdigital neuroma score and the patients were asked in terms of the level of pain, shoe modification, and sensorial problems. Results: Average interdigital neuroma score improved from 20 to 62 points following the surgery (p<0.05). An excellent interdigital neuroma score was reported in 11 cases (41%), well in 13 (48%) and fair in one patient (4%); and two patients (7%) had a poor result with a similar pain prior to surgery. Numbness was reported in 16 patients (59%) without a restriction in daily life. Seven patients (26%) reported mild limitation with fashionable shoes and one patient (4%) reported severe intolerance in footwear. 19 patients (70%) were completely pain-free. Conclusion: Surgical excision via dorsal approach is an effective method for the treatment of Morton’s neuroma. In spite of the fact that mild degree shoe modification and numbness were the most common existing symptoms after the surgery, clinical scores were not related to ongoing symptoms.