Retrospective analysis of intermetatarsal neuroma excision with preservation of the transverse metatarsal ligament.

The authors present a retrospective analysis of intermetatarsal neuroma excision with preservation of the transverse metatarsal ligament. They reviewed a series of 43 patients who had undergone a total of 59 such surgical resections. No other surgical procedures were performed on the foot. The patients included 36 women, and 7 men. Follow-up ranged from 1 year and 5 months to 6 years and 3 months with an average of 4 years and 3 months. Fifty-one of the neuromas removed were in the third interspace, three in the second interspace, and five in the fourth interspace. The surgical excision was performed in standard fashion except for the major modification of preservation of the transverse metatarsal ligament. There were 47 excellent or good results and, thus, the overall success rate was 79%. Seven patients had fair results and five had poor results. The results compare favorably with those reported by other authors who advocate transecting the transverse metatarsal ligament. The authors conclude that their approach to surgical excision of intermetatarsal neuromas is valid while preservation of the normal ligamentous anatomy is maintained.