Related Experiment Video
Updated: Jun 15, 2026
Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
Single metatarsal percutaneous distal metatarsal osteotomy (DMMO) for 3rd space morton neuroma is safe and
Alirio J deMeireles1, Mariano de Prado2,3,4,5, Jamie Confino1
1Columbia University Irving Medical Center, New York, NY, USA.
Introduction:
Morton's interdigital neuroma (MN) is a common compression neuropathy of an interdigital nerve in the foot. We present retrospective treatment outcomes with a novel modification of the de Prado technique for distal minimally invasive metatarsal osteotomy (DMMO).
Methods:
We retrospectively reviewed 25 consecutive patients (25 neuromas) with MRI- or US-confirmed MN who underwent DMMO of only the 4th metatarsal with deep transverse intermetatarsal ligament release with a minimum one-year follow-up after the failure of non-operative treatment. Patient-reported outcome measures (PROMs) were assessed using the Visual Analog Scale (VAS) and the Foot Function Index (FFI). Statistical analysis was performed to assess for differences among sub-groups.
Results:
A significant decrease is reported post-operatively in all PROMs evaluated. Pre- and post-intervention mean VAS scores were 7.35 and 0.41, respectively (p < 0.001). Pre- and post-intervention FFI Total scores were 57.5 and 17.2, respectively (p < 0.001). All pre- and post-intervention FFI sub-scores were found to be significantly reduced (P < 0.001). There was one case of prolonged serous (non-infected) drainage, which resolved by three weeks postoperatively.
Conclusions:
The data presented demonstrates that our novel operative technique significantly improved patient-reported outcomes irrespective of initial neuroma size, patient sex, or comorbidities.
Level Of Evidence:
IV.
Insights
A novel surgical technique for Morton's interdigital neuroma (MN) significantly improved patient outcomes. This minimally invasive approach offers effective relief for foot pain, enhancing function and quality of life.
Area of Science:
- Orthopedic Surgery
- Podiatric Medicine
- Neurology
Background:
- Morton's interdigital neuroma (MN) is a prevalent nerve compression issue in the foot.
- Current treatments often fail, necessitating surgical intervention.
Purpose of the Study:
- To evaluate the outcomes of a modified distal minimally invasive metatarsal osteotomy (DMMO) for treating Morton's neuroma.
- To assess the efficacy of a novel surgical technique in improving patient-reported outcomes.
Main Methods:
- Retrospective review of 25 patients with confirmed Morton's neuroma.
- Surgical intervention involved DMMO of the 4th metatarsal and deep transverse intermetatarsal ligament release.
- Patient-reported outcome measures (PROMs) including VAS and FFI were assessed at minimum one-year follow-up.
Main Results:
- Significant improvements were observed in all PROMs post-surgery.
- Mean VAS scores decreased from 7.35 to 0.41 (p < 0.001).
- Mean FFI Total scores reduced from 57.5 to 17.2 (p < 0.001), with significant decreases in all sub-scores.
Conclusions:
- The modified DMMO technique demonstrates significant efficacy in improving patient-reported outcomes for Morton's neuroma.
- Treatment success was independent of neuroma size, patient sex, or comorbidities.
- This minimally invasive approach provides a viable surgical option for refractory Morton's neuroma.
More Related Videos
06:26The Third Channel-Assisted Unilateral Biportal Endoscopic Technique for Lumbar Spinal Stenosis Combined with Contralateral Disc Herniation
Published on: November 17, 2023
05:17Percutaneous Endoscopic Unilateral-Approach Bilateral Decompression for Lumbar Spinal Stenosis
Published on: February 9, 2024