Abstract
The entrapment theory is the most commonly accepted theory concerning the development of interdigital neuroma; it incriminates the deep transverse metatarsal ligament as the major causative factor of the condition. This report presents a patient with interdigital neuroma in the second intermetatarsal space, which was strongly suspected to be caused by the metatarsophalangeal joint instability due to plantar plate injury. Surgical intervention revealed that the neuroma was located more distally and dorsally than the deep transverse metatarsal ligament and was pinched between the adjacent metatarsal heads, suggesting the involvement of the metatarsophalangeal joint instability and chronic trauma as etiologies in this case.
Highlights
Interdigital neuroma in the foot, generally known as Morton’s neuroma, is a painful condition that produces neuropathic pain in the distribution of the affected interdigital nerve [1]
Because overlooking MTP joint instability can lead to residual pain after neurectomy for interdigital neuroma [4], it is important to understand the relationship between these two pathologies
A reported higher prevalence of the second intermetatarsal space neuroma in cases with the second MTP joint instability compared to the prevalence of the second intermetatarsal space neuroma in the general population strongly suggests an association between these two pathologies
Summary
Interdigital neuroma in the foot, generally known as Morton’s neuroma, is a painful condition that produces neuropathic pain in the distribution of the affected interdigital nerve [1]. A high prevalence of coexisting second intermetatarsal space neuroma and second MTP joint instability has been reported [3]; there has been little discussion about the possible etiologic relationship between these two pathologies [3]. We report a case of interdigital neuroma in the second intermetatarsal space accompanied with MTP joint instability of the second and third toes due to plantar plate rupture. The symptoms were completely resolved after neurectomy and plantar plate reconstruction of the second and third MTP joints. This case strongly supports the chronic trauma theory as one of the etiologies of interdigital neuroma and indicates a possible causal relationship between interdigital neuroma and MTP joint instability
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