Morton's neuroma as a surgical example of entrapment syndrome

Abstract

Morton's neuroma is a misnomer in the sense that the digital nerve lesion in question is not a true neuroma of a nerve, but rather, perineural fibrosis. Nonetheless, for many decades, optimal treatment for its metatarsalgia was nerve resection due to the fact it was an identifiable anatomical mass. Dellon 1 Dellon A.L. Treatment of morton's neuroma as a nerve compression. The role for neurolysis.. J Am Podiatr Med Assoc. 1992; 82: 399-402 Crossref PubMed Scopus (55) Google Scholar in 1992 popularized the theory that the pain derived in fact from digital nerve compression by the deep transverse intermetatarsal ligament. Then it stood to reason pain caused by nerve entrapment could be relieved with a decompressive neurolysis without resecting the nerve, eliminating the risk of (stump) neuroma pain as well as preserving sensory function. This is often best done from the dorsal aspect of the foot, given the appropriate exposure of the ligament can be reliably achieved with a perceived shorter time to postoperative weight-bearing. What has been unclear to date is the long-term effectiveness of this the dorsal decompressive approach by Dellon, and Mischitz et al. 2 Mischitz M. Zeitlinger S. Michlinger J. Rab M Nerve decompression according to A.L. Dellon in Morton neuroma - A retrospective analysis.. J Plastic Reconstr Aesthet Surg. 2020; Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar show in their article that it does afford very favorable pain, foot function, and skin sensibility outcomes years after surgery. Nerve decompression according to A.L. Dellon in Morton's neuroma - A retrospective analysisJournal of Plastic, Reconstructive & Aesthetic SurgeryVol. 73Issue 6PreviewFirst reported by Dellon et al. in 1992, nerve decompression by dissecting the deep transversal intermetatarsal ligament through a dorsal incision appears to be a reliable method for treating Morton's neuroma by addressing its underlying pathomechanism, since it should rather be considered as Morton's entrapment. As there are no current studies dealing with Dellon's surgical technique, we carried out a retrospective analysis with the aim of showing that nerve decompression is an effective method to treat Morton's neuroma, and one that considers its true pathology. Full-Text PDF