Caio Nery1, Fernando Raduan1, Angelo Del Buono2, Inacio Diogo Asaumi1, Nicola Maffulli3. 1. Department of Orthopaedic Surgery, Federal University of São Paulo, R. Pedro de Toledo 783, Fifth Floor, Vila Mariana, São Paulo, São Paulo, Brazil 04039-032. E-mail address for C. Nery: caionery@uol.com.br. E-mail address for F. Raduan: fernando@raduan.com.br. E-mail address for I.D. Asaumi: igasaumi@uol.com.br. 2. Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy. E-mail address: a.delbuono@unicampus.it. 3. Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England. E-mail address: n.maffulli@qmul.ac.uk.
Abstract
INTRODUCTION: The plantar approach for management of a Morton neuroma allows the transverse metatarsal ligament to be spared, decreases the risk of damage to the dorsal cutaneous nerve branches, and has a low rate of complications with results comparable with those of other approaches. STEP 1 INCISION: Make a transverse plantar skin incision distal to the metatarsal weight-bearing area. STEP 2 EXPOSURE: Excise the connective tissues around the neuroma and expose the common digital nerve as far proximally as possible. STEP 3 RESECTION: Identify the resection point over the metatarsal neck and cut the neural branches as proximal and as distal as possible. STEP 4 CLOSURE: Suture the fat pad using inverting absorbable sutures and the skin using nonabsorbable monofilament sutures. RESULTS: We assessed 160 of 168 patients who had undergone surgical excision of a Morton neuroma; the median duration of follow-up was 7.1 years13. WHAT TO WATCH FOR: IndicationsContraindicationsPitfalls & Challenges.
INTRODUCTION: The plantar approach for management of a Morton neuroma allows the transverse metatarsal ligament to be spared, decreases the risk of damage to the dorsal cutaneous nerve branches, and has a low rate of complications with results comparable with those of other approaches. STEP 1 INCISION: Make a transverse plantar skin incision distal to the metatarsal weight-bearing area. STEP 2 EXPOSURE: Excise the connective tissues around the neuroma and expose the common digital nerve as far proximally as possible. STEP 3 RESECTION: Identify the resection point over the metatarsal neck and cut the neural branches as proximal and as distal as possible. STEP 4 CLOSURE: Suture the fat pad using inverting absorbable sutures and the skin using nonabsorbable monofilament sutures. RESULTS: We assessed 160 of 168 patients who had undergone surgical excision of a Morton neuroma; the median duration of follow-up was 7.1 years13. WHAT TO WATCH FOR: IndicationsContraindicationsPitfalls & Challenges.