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Isolated Intermetatarsal Ligament Release as Primary Operative Management for Morton's Neuroma: Short-term Results
Mohamed Abdelaziz Elghazy1,2,3,4,5, Kathryn C Whitelaw1,2,3,4,5, Gregory R Waryasz1,2,3,4,5
1Foot and Ankle Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (MAE, GRW, KCW).
Background:
Although the precise pathoetiology of Morton's neuroma remains unclear, chronic nerve entrapment from the overlying intermetatarsal ligament (IML) may play a role. Traditional operative management entails neuroma excision but risks unpredictable formation of stump neuroma.
Materials And Methods:
Medical records were examined for adult patients who failed at least 3 months of conservative treatment for symptomatic and recalcitrant Morton's neuroma and who then underwent isolated IML decompression without neuroma resection.
Results:
A total of 12 patients underwent isolated IML decompression for Morton's neuroma with an average follow-up of 13.5 months. Visual Analog Pain Scale averaged 6.4 ± 1.8 (4-9) preoperatively and decreased to an average of 2 ± 2.1 (0-7) at final follow-up (P = .002). All patients reported significant improvement.
Conclusion:
Isolated IML release of chronically symptomatic Morton's neuroma shows promising short-term results regarding pain relief, with no demonstrated risk of recurrent neuroma formation, permanent numbness, or postoperative symptom exacerbation.
Level Of Evidence:
Level IV: Case series.
