Clinical outcomes of neurectomy in Morton’s neuroma

Abstract

Objective: The purpose of this study is to show the clinical results of patients operated on for interdigital neuroma (IDN) in the third and second intermetatarsal spaces with neurectomy and had at least two years of follow up. Methods: Twenty-eight (28) patients with 32 surgical procedures were included and evaluated by personal examination and review of their records. Mean follow up was of 8,5 years. Pain was registered on the Visual Analogical Scale (VAS). Patients were asked to characterize shoe and recreational activities according to Coughlin & Pinsonneault and were asked to rate their overall satisfaction according to the Coughlin scale. Numbness in the operated area was tested both subjectively and objectively. Results: The mean age at surgery was 58,1 years. 90,6% of all patients were operated on the third space. The VAS scale showed an average score of 1,3 postoperatively (previous, 8,8). Twenty-six (26) patients (81,3%) had no shoe restrictions and 29 (90,6%) had no recreational restrictions after surgery. Overall satisfaction was rated as excellent by 22 patients (68,8%), good by 8 (25%), fair by one (3,1%) and poor by one (3,1%). The sensory postoperative examination showed both subjective sensation of numbness and objective findings. The area of residual numbness showed an uneven pattern. Conclusions: Neurectomy in the setting of IDN is a successful method of treatment with consecutive absence of pain or pain relief. Patients so operated have none o few shoe and recreational restrictions and rate high satisfaction with the surgical procedure. Sensory deficits are variable and so is the area affecting the tip of the toes, the plantar aspect of the web space and the area between the toes. Level of Evidence IV