eMedicine Specialties > Orthopedic Surgery > Foot & Ankle

Morton Neuroma: Follow-up

Author: Thomas M Schaller, MD, Clinical Assistant Professor, Department of Orthopedic Surgery, Kalamazoo Center for Medical Studies, Michigan State University; Medical Director of Orthopedic Trauma, Bronson Methodist Hospital
Contributor Information and Disclosures

Updated: May 9, 2008

Outcome and Prognosis

In general, review of the orthopedic literature from the last 20 years supports an estimate of 75-85% satisfactory results after surgical intervention. Nonsurgical management probably results in a 20-30% success rate.

Long-term postsurgical outcomes have been quantified thoroughly by Coughlin and Pinsonneault.15 Their study monitored 76 patients over an average of 5.8 years. A dorsal approach was used, and a neurectomy was performed 3 cm proximal to the intermetatarsal ligament. The results were as follows:

  • Approximately one third of patients have some persisting scar sensitivity when examined that was not identified by the patients prior to being examined. Thus, it was likely minimally significant.
  • Residual interspace tenderness was present in 61% when examined, but only 6 of those 45 patients had identified this as a persisting problem prior to being examined.
  • No instances of metatarsal joint instability were reported.
  • Intractable plantar keratosis developed in 15%.
  • Subjective numbness was noted by 51% of patients, but only 4 of 71 patients found it problematic.
  • Seventy percent of patients had footwear restrictions, and 38% had some persisting activity modifications.
  • Wound complications occurred in 2 of 74 incisions and were mild.

Future and Controversies

This article outlines some current controversies regarding Morton neuroma; the fact that the eponym is likely a misnomer is a reflection of current controversies. The histology, use of adjunctive imaging modalities, and choice of surgical procedure all involve some degree of controversy. Current and future work is addressing these issues.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor Patrick L. O'Connor, MD, to the development and writing of this article.



More on Morton Neuroma

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References
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References

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Further Reading

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Keywords

interdigital neuroma, interdigital neuritis, forefoot pain, forefoot paresthesias, forefoot numbness, foot pain, Inge retractor, neurectomy, plantar keratosis

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Contributor Information and Disclosures

Author

Thomas M Schaller, MD, Clinical Assistant Professor, Department of Orthopedic Surgery, Kalamazoo Center for Medical Studies, Michigan State University; Medical Director of Orthopedic Trauma, Bronson Methodist Hospital
Thomas M Schaller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Medical Association, AO Foundation, and Orthopaedic Trauma Association
Disclosure: Nothing to disclose.

Medical Editor

Heidi M Stephens, MD, MBA, Associate Professor, Department of Surgery, Division of Orthopedic Surgery, University of South Florida College of Medicine; Courtesy Joint Associate Professor, Department of Environmental and Occupational Health, University of South Florida College of Public Health
Heidi M Stephens, MD, MBA is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Foot and Ankle Society, and Florida Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Shepard R Hurwitz, MD, Executive Director, American Board of Orthopaedic Surgery
Shepard R Hurwitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for the Advancement of Science, American College of Rheumatology, American College of Sports Medicine, American College of Surgeons, American Diabetes Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Association for the Advancement of Automotive Medicine, Eastern Orthopaedic Association, Orthopaedic Research Society, Orthopaedic Trauma Association, and Southern Orthopaedic Association
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Jason H Calhoun, MD, FACS, Frank J Kloenne Chair in Orthopedic Surgery, Professor and Chair, Department of Orthopedics, The Ohio State University Medical Center
Jason H Calhoun, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, American Diabetes Association, American Medical Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Missouri State Medical Association, Musculoskeletal Infection Society, Southern Medical Association, Southern Orthopaedic Association, Texas Medical Association, and Texas Orthopaedic Association
Disclosure: Nothing to disclose.

 
 
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