IJCM  Vol.4 No.1 , January 2013
The Treatment of Morton’s Neuroma, a Significant Cause of Metatarsalgia for People Who Exercise
ABSTRACT

Morton’s Neuroma is a common metatarsalgia in athletes created due to the entrapment of the inter-digital nerve inside the transverse inter-metatarsal ligament. The purpose of the present study is to draw the necessary conclusions from the use of a particular surgical treatment to release the digital nerve, accompanied by neurolysis in adults who exercise. On the whole, twenty five patients with twenty-five suffering extremities were treated. Five of them simultaneously had a Hallux Valgus type deformity and that supports the belief of the mechanical induce of this condition. Both ultrasonography and Magnetic Resonance Imaging (MRI) were used for the clinical evaluation of this condition. The pain was estimated via the Visual Analogue Scale (VAS). The patients were re-examined after three (1st postoperative), twelve (2nd postoperative) and twenty-four (3rd postoperative) months. A significant improvement (p < 0.0001) was noticed from the correlation between the pain before the surgery and the pain after the surgery via the Visual Analogue Scale (VAS). Most patients (15/25) did not display any discomfort or sensory disorder after surgery. The correct clinical evaluation as well as the correct and effective surgical intervention with the simultaneous repair of all the mechanical deformities of the foot provided better post-surgery progress in patients and increased the percentage of their rehabilitation of their previous activities.


Cite this paper
B. Konstantine, T. Anastasia, B. Catherine, T. George and K. Pavlos, "The Treatment of Morton’s Neuroma, a Significant Cause of Metatarsalgia for People Who Exercise," International Journal of Clinical Medicine, Vol. 4 No. 1, 2013, pp. 19-24. doi: 10.4236/ijcm.2013.41005.
References
[1]   K. K. Wu, “Morton Neuroma and Metatarsalgia,” Current Opinion in Rheumatology, Vol. 12, No. 2, 2000, pp. 131-142. doi:10.1097/00002281-200003000-00007

[2]   K. K. Wu, “Morton’s Interdigital Neuroma: A Clinical Review of Its Etiology, Treatment, and Results,” The Journal of Foot and Ankle Surgery, Vol. 35, No. 2, 1996, pp. 112-119. doi:10.1016/S1067-2516(96)80027-5

[3]   A. Pace, B. Scammell and S. Dhar, “The Outcome of Morton’s Neurectomy in the Treatment of Metatarsalgia,” International Orthopaedics, Vol. 34, No. 4, 2010, pp. 511-515. doi:10.1007/s00264-009-0812-3

[4]   P. J. Numan and B. D. Giesy, “Management of Morton’s Neuroma in Athletes,” Clinics in Podiatric Medicine and Surgery, Vol. 14, No. 3, 1997, pp. 489-501.

[5]   L. C. Schon and D. E. Baxter, “Neuropathies of the Foot and Ankle in Athletes,” Clinics in Sports Medicine, Vol. 9, No. 2, 1990, pp. 489-509.

[6]   G. Gauthier, “Thomas Morton’s Disease: A Nerve Entrapment Syndrome. A New Surgical Technique,” Clinical Orthopaedics and Related Research, Vol. 142, 1979, pp. 90-92.

[7]   C. E. Graham and D. M. Graham, “Morton’s Neuroma: A Microscopic Evaluation,” Foot & Ankle, Vol. 5, No. 3, 1984, pp. 150-153.

[8]   M. M. Ruuskanen, T. Niinimaki and P. Jalovaara, “Results of the Surgical Treatment of Morton’s Neuralgia in 58 Operated Intermetatarsal Spaces Followed over 6 (2-12) Years,” Archives of Orthopaedic and Trauma Surgery, Vol. 113, No. 2, 1994, pp. 78-80. doi:10.1007/BF00572909

[9]   H. Breivik, P. C. Borchgrevink, S. M. Allen, L. A. Rosseland, L. Romundstad, E. K. Breivik Hals, G. Kvarstein and A. Stubhaug, “Assessment of Pain,” British Journal of Anaesthesia, Vol. 101, No. 1, 2008, pp. 17-24. doi:10.1093/bja/aen103

[10]   M. R. Hedrick and A. M. McBryde, “Posterior Ankle Impingement,” Foot & Ankle International, Vol. 15, No. 1, pp. 2-8.

[11]   R. J. Sharp, C. M. Wade, M. S. Henessy and T. S. Saxby, “The Role of MRI and Ultrasound Imaging in Mortons Neuroma and the Effect of Size of Lesion on Symptoms,” Journal of Bone and Joint Surgery, Vol. 85, No. 7, 2003, pp. 999-1005. doi:10.1302/0301-620X.85B7.12633

[12]   D. Weishaupt, K. Treiber, H. P. Kundert, H. Zollinger, P. Vienne, J. Hodler, J. K. Willmann, B. Marincek and M. Zanetti, “Morton Neuroma: MR Imaging in Prone, Supine, and Upright Weight-Bearing Body Positions,” Radiology, Vol. 226, No. 3, 2003, pp. 849-856. doi:10.1148/radiol.2263011925

[13]   M. J. Lee, S. Kim, Y. M. Huh, H. T. Song, S. A. Lee, J. W. Lee and J. S. Suh, “Morton Neuroma: Evaluated with Ultrasonography and MR imaging,” Korean Journal of Radiology, Vol. 8, No. 2, 2007, pp. 148-155. doi:10.3348/kjr.2007.8.2.148

 
 
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