Is endoscopic decompression for Morton's neuroma a safe technique?

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Minimally Invasive Procedures

Background:

• Morton's neuroma results from nerve entrapment, often treated conservatively.
• Surgical options include neurectomy and deep transverse metatarsal ligament (DTML) release for treatment failures.
• Assessing anatomical risks of endoscopic dorsal decompression is crucial.

Purpose of the Study:

• To anatomically evaluate the risks of 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 anatomical dissections assessed risks to surrounding structures.

Main Results:

• The deep transverse metatarsal ligament (DTML) was successfully sectioned in all specimens (100%).
• No iatrogenic injuries to tendons, nerves, or arteries were observed.
• Potential risk to lumbrical muscles was identified.

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 may be needed regarding lumbrical muscle safety.