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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
PubMed
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.

Keywords:
Cirugía endoscópicaDeep transverse metatarsal ligamentEndoscopic surgeryLigamento intermetatarsiano transverso profundoMorton's neuromaNeuroma de Morton

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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.