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Interdigital Neuritis: Diagnosis and Treatment.

Weinfeld1, Myerson

  • 1Department of Orthopaedics, Mount Sinai School of Medicine, New York, and Mount Sinai Medical Center.

The Journal of the American Academy of Orthopaedic Surgeons
|November 1, 1996
PubMed
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Interdigital neuritis, often called Morton's neuroma, may stem from inflammation rather than nerve growth. Surgical treatment recommendations focus on a dorsal approach with ligament release, avoiding nerve excision unless for revision surgery.

Area of Science:

  • Podiatry
  • Orthopedic Surgery
  • Neurology

Background:

  • The condition commonly known as Morton's neuroma lacks a definitive etiological understanding, with debate on whether it involves true neuromatous proliferation or inflammation.
  • The term "interdigital neuritis" is proposed as a more accurate descriptor due to this uncertainty.

Purpose of the Study:

  • To review the etiology, diagnosis, and management of interdigital neuritis.
  • To compare surgical approaches, specifically plantar versus dorsal, and evaluate the efficacy of neurectomy versus transverse metatarsal ligament incision.

Main Methods:

  • Review of existing literature on interdigital neuritis.
  • Analysis of diagnostic criteria based on history and clinical examination.
  • Evaluation of surgical techniques, including dorsal approach, transverse ligament release, and neurectomy.

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Main Results:

  • Diagnosis of interdigital neuritis should rely on clinical assessment.
  • A dorsal surgical approach with release of the transverse ligament, without neurectomy, is recommended for initial surgery.
  • Revision surgery involves a dorsal incision with nerve excision proximal to the transverse ligament.

Conclusions:

  • Interdigital neuritis is the preferred term for the condition.
  • Conservative management and clinical diagnosis are emphasized.
  • Specific surgical strategies are recommended for primary and revision cases to optimize outcomes.