The recurrent Morton neuroma: what now?

Interdigital neuromas are a common cause of forefoot pain, and approximately 80% of patients require surgical excision for symptom relief. Although 50% to 85% of patients obtain relief after primary excision, symptoms may recur because of an incorrect diagnosis, inadequate resection, or adherence of pressure on a nerve stump neuroma. The symptom relief rate after reoperation is similar to that after primary excision. A plantar longitudinal incision provides optimal exposure, and transposition of the nerve stump into bone or muscle and avoids traction or pressure on the nerve ending that can result in a painful stump neuroma. Preoperative counseling is essential to align patient expectations with potential outcomes.