Sensory nerve neuromas--leading to failed foot surgery

Sensory nerve neuromas caused by incisions on the dorsum of the foot are a common cause of failed foot surgery and can be severely painful and disabling. Thirty-seven patients with 55 symptomatic sensory nerve neuromas were evaluated and treated at the Painful Foot Center. Ten patients with moderately severe symptoms chose not to undergo surgery and were treated with oversized shoes with or without protective orthoses. Twenty-seven patients underwent surgery. Four with spindle neuromas were treated by neurolysis. Two improved slightly, one remained the same, and one became worse. Twenty-three were treated by proximal resection with or without burial of the nerve stump into an appropriate muscle belly. Thirteen of the 23 obtained good results, four obtained fair results, and six obtained poor results. Thus, a total of 20 patients (74%) obtained clinically satisfactory results, and seven (26%), unsatisfactory results. It is much easier to prevent a sensory neuroma by meticulous surgical technique than to treat a highly symptomatic neuroma.