Is endoscopic decompression for Morton's neuroma a safe technique?
L López-Capdevila1, M Ballester2, G Lucar2
1Hospital Santa Creu i Sant Pau, Barcelona, Spain.
Revista Espanola De Cirugia Ortopedica Y Traumatologia
|October 12, 2024
Summary
Endoscopic dorsal decompression effectively treats Morton's neuroma by releasing the deep transverse metatarsal ligament. This minimally invasive approach shows low risk to surrounding structures, offering a viable surgical option.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
- Minimally Invasive Procedures
Background:
- Morton's neuroma results from nerve entrapment, often treated conservatively.
- Failed conservative treatments necessitate surgical interventions like neurectomy or ligament release.
- Assessing anatomical risks of endoscopic dorsal decompression is crucial.
Purpose of the Study:
- To anatomically evaluate risks associated with endoscopic dorsal surgical decompression for Morton's neuroma.
- To determine the safety and efficacy of this minimally invasive technique.
Main Methods:
- Twenty feet from ten cadaveric specimens were used.
- A dorsal percutaneous approach facilitated endoscopic access.
- Post-procedure dissection assessed iatrogenic injuries to surrounding structures.
Main Results:
- The deep transverse metatarsal ligament (DTML) was successfully sectioned in 100% of specimens.
- No iatrogenic injuries to tendons, nerves, or arteries were observed.
- Lumbrical muscles were identified as potentially at risk.
Conclusions:
- Endoscopic dorsal decompression is an accessible, minimally invasive surgical option for Morton's neuroma.
- The procedure demonstrates a low risk of collateral injuries.
- Further evaluation of lumbrical involvement may be warranted.
