Plantar Approach for a Morton Neuroma: Surgical Technique

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.

Make a transverse plantar skin incision distal to the metatarsal weight-bearing area.

Excise the connective tissues around the neuroma and expose the common digital nerve as far proximally as possible.

Identify the resection point over the metatarsal neck and cut the neural branches as proximal and as distal as possible.

Suture the fat pad using inverting absorbable sutures and the skin using nonabsorbable monofilament sutures.

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.

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