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intermetatarsal neuroma

Y H Park, S M Jeong, G W Choi, H J Kim
AIMS: Morton's neuroma is common condition of the forefoot, but its aetiology remains unclear. Our aim was to evaluate the relationship between the width of the forefoot and the development of a Morton's neuroma. PATIENTS AND METHODS: Between January 2013 and May 2016, a total of 84 consecutive patients (17 men, 67 women) with a unilateral Morton's neuroma were enrolled into the study. The involved and uninvolved feet of each patient were compared. A control group of patients with symptoms from the foot, but without a neuroma who were matched for age, gender, affected side, and web space location, were enrolled...
March 2017: Bone & Joint Journal
Takumi Matsumoto, Song Ho Chang, Naohiro Izawa, Yohei Ohshiro, Sakae Tanaka
The entrapment theory is the most commonly accepted theory concerning the development of interdigital neuroma; it incriminates the deep transverse metatarsal ligament as the major causative factor of the condition. This report presents a patient with interdigital neuroma in the second intermetatarsal space, which was strongly suspected to be caused by the metatarsophalangeal joint instability due to plantar plate injury. Surgical intervention revealed that the neuroma was located more distally and dorsally than the deep transverse metatarsal ligament and was pinched between the adjacent metatarsal heads, suggesting the involvement of the metatarsophalangeal joint instability and chronic trauma as etiologies in this case...
2016: Case Reports in Orthopedics
Lana H Gimber, David M Melville, Darin A Bocian, Elizabeth A Krupinski, Matthew P Del Guidice, Mihra S Taljanovic
OBJECTIVE: The objective of our study was to retrospectively assess for differences in imaging appearances of Morton neuromas before and after laser therapy using diagnostic ultrasound (US). MATERIALS AND METHODS: A retrospective review was performed to identify patients who underwent US imaging to evaluate for Morton neuroma during the study period (June 1, 2013-July 1, 2014); of the 42 patients identified, 21 underwent US evaluations before and after laser therapy...
February 2017: AJR. American Journal of Roentgenology
Reza Naraghi, Alexandra Bremner, Linda Slack-Smith, Alan Bryant
BACKGROUND: The aim of this research was to investigate the association of various structural measurements of the forefoot with Morton's neuroma (MN). METHODS: Weightbearing anteroposterior and lateral foot radiographs of subjects attending the University of Western Australia (UWA) Podiatry Clinic and the first author's private practice were included in this study. A single assessor measured the following angles: lateral intermetatarsal angle (LIMA), intermetatarsal angle (IMA), hallux valgus angle (HVA), digital divergence between the second and third digits (DD23), digital divergence between the third and fourth digits (DD34) and relative metatarsal lengths of the first to fifth metatarsals (Met1-5), and the effect of MN size as measured by ultrasonograph on digital divergence...
March 2017: Foot & Ankle International
Stuart L Cohen, Theodore T Miller, Scott J Ellis, Matthew M Roberts, Edward F DiCarlo
OBJECTIVES: To determine what accounts for the sonographic appearance of a Morton neuroma by correlating preoperative sonograms with the sonographic appearance of the resected surgical specimen, the surgical findings, and the pathologic examination. METHODS: Ten Morton neuromas that had preoperative sonograms underwent postoperative specimen sonography and histologic evaluation. The appearance and size of the neuromas were compared between the preoperative and postoperative specimen images and were compared to the surgical and pathologic appearances...
October 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Tun Hing Lui
Morton neuroma is an entrapment of the intermetatarsal nerve by the deep intermetatarsal ligament. It is usually treated conservatively. Surgery is considered if there is recalcitrant pain that is resistant to conservative treatment. The surgical options include resection of the neuroma or decompression of the involved nerve. Decompression of the nerve by release of the intermetatarsal ligament can be performed by either an open or minimally invasive approach. We describe 2-portal endoscopic decompression of the intermetatarsal nerve...
December 2015: Arthroscopy Techniques
Robert G Parker, Orlando Merced-O'Neil
Painful recurrent stump neuroma presents a common clinical problem following the transection of a nerve after initial interdigital neuroma excision but there is no gold standard of treatment. A patient presented with pain symptoms consistent with recurrent intermetatarsal stump neuroma after undergoing previous surgery to excise a Hauser neuroma. The recurrent stump neuroma was excised and the resulting nerve was capped and implantation into intrinsic muscle. Postoperatively, the patient experienced a complete resolution of pain and return of normal function...
April 2016: Clinics in Podiatric Medicine and Surgery
Tugrul Ormeci, Olcay Güler, Melih Malkoc, Mert Keskinbora, Fatma Zeynep Güngören, Mahir Mahirogulları
The objective of the present study was to characterize the ultrasound and elastographic properties of intermetatarsal neuroma (interdigital neuroma) and their contribution to diagnosis. Eighteen patients with metatarsalgia, who had presented to an orthopedic clinic from April 2013 to February 2015, were diagnosed with 25 intermetatarsal neuromas (11 unilateral [61.11%], 7 bilateral [38.89%]). These patients underwent evaluation with ultrasonography and simultaneous ultrasound strain elastography to assess the elastographic properties of the tissues in the intermetatarsal space...
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Claudia M Campbell, Eric Diamond, William K Schmidt, Margaret Kelly, Robert Allen, William Houghton, Kerrie L Brady, James N Campbell
Intermetatarsal neuroma or Morton's neuroma is a painful condition of the foot resulting from an entrapment of the common digital nerve typically in the third intermetatarsal space. The pain can be severe and especially problematic with walking. Treatment options are limited and surgery may lead to permanent numbness in the toes. Capsaicin, the pungent ingredient of hot peppers, produces analgesia by inducing retraction of nociceptive afferents from the area of innervation and is effective in treating certain neuropathic pain disorders...
June 2016: Pain
Vanessa Dinoá, Felipe von Ranke, Flavia Costa, Edson Marchiori
OBJECTIVE: To present findings of plantar plate (PP) lesions from MRI with administration of gadolinium and to differentiate PP lesions from others causes of metatarsalgia. MATERIALS AND METHODS: Two musculoskeletal radiologists reviewed 249 contrast-enhanced forefoot MRI scans from patients with metatarsalgia between June 2012 and June 2013. Evaluations focused on hyper-vascularized/fibrous tissue and other findings associated with PP tears. RESULTS: Fifty-nine patients had PP tears, 59 % were female...
May 2016: Skeletal Radiology
Luciano Perini, Claudia Perini, Matteo Tagliapietra, Davide Varotto, Andrea Valcarenghi, Andrea Postorino, Antonio Volpe
PURPOSE: To evaluate the efficacy and safety of percutaneous treatment of Civinini-Morton's syndrome due to solitary Morton's neuroma and analyze the effect of clinico-demographic factors on outcome. MATERIALS AND METHODS: Alcohol injection was performed under sonographic guidance in 220 consecutive patients. Pain intensity using a numerical rating scale (NRS), pain features, limitation of everyday activities and comorbidity with other forefoot conditions were evaluated at presentation...
July 2016: La Radiologia Medica
Mitsuaki Kubota, Ryuichi Ohno, Muneaki Ishijima, Ryo Hanyu, Kensuke Sakai, Yu Sugawara, Hironori Ochi, Humihiro Mukasa, Kazuo Kaneko
BACKGROUND: We presented case reports of endoscopic decompression for a Morton intermetatarsal neuroma. METHODS: Three patients underwent surgery using an instrument designed to release the transverse carpal ligament for carpal tunnel syndrome. Each patient was 61, 56 and 24 years old. The mean follow up period was 1.5 years. RESULTS: All patients experienced reduced pain postoperatively. The postoperative scar was very small (only 1 cm). There is no loss of sensation, no hematoma and no infection...
October 2015: Journal of Orthopaedics
Maximilian Kasparek, Wolfgang Schneider
PURPOSE: Although operative excision is regarded as the treatment of choice in Morton's neuroma, it remains unclear whether transection of deep transverse metatarsal ligament (DTML) is a risk for metatarsal splaying and whether simultaneous surgery in adjacent intermetatarsal spaces is a risk for osteonecrosis of the adjacent metatarsals. METHODS: Fifty-seven feet in 47 patients had excision of a Morton's neuroma, with a mean follow-up of 15.3 years. Feet were categorised depending upon whether the DTML was or was not divided...
May 2016: International Orthopaedics
Suleyman Deniz, Tarik Purtuloglu, Sukru Tekindur, Kadir Hakan Cansız, Memduh Yetim, Oguz Kılıckaya, Serkan Senkal, Serkan Bilgic, Abdulkadir Atim, Ercan Kurt
BACKGROUND: Morton's neuroma is a perineural fibrosis of an intermetatarsal plantar nerve. Burning, numbness, paresthesia, and tingling down the interspaces of involved toes may also be experienced. Taking into account all of this information, we designed a prospective open-label study to evaluate the efficacy of pulsed radio frequency on Morton's neuroma. METHODS: Twenty patients with Morton's neuroma were experiencing symptomatic neuroma pain in the foot not relieved by routine conservative treatment...
July 2015: Journal of the American Podiatric Medical Association
Hilary Umans, Ramya Srinivasan, Elisabeth Elsinger, Gregory E Wilde
OBJECTIVE: To identify the variety of second and third intermetatarsal space (IS) lesions that may coexist with and without adjacent metatarsophalangeal joint (MTP) plantar plate (PP) tears. MATERIALS AND METHODS: One hundred forefoot MRIs in 96 patients with metatarsalgia obtained between 30 September 2011 and 21 July 2012 using 1.5- or 3-T MRI were retrospectively reviewed in consensus by two MSK radiologists and one podiatrist (DPM). MRI was evaluated for second and third MTP PP tear and the presence/nature of second and third IS lesions...
October 2014: Skeletal Radiology
B A Nelms, J O Bishop, H S Tullos
In this series, 27 patients underwent surgery for recurrent Morton's neuroma through a plantar incision. All patients were women, with an age range of 35 to 65 years. Followup ranged from 12 months to three years. Twenty-one patients had recurrent neuromas in the third intermetatarsal space, and six patients had recurrence in the second intermetatarsal space.Twenty-four of 27 patients had excellent or good results, a success rate of 89%. Three patients with poor results had undergone previous surgery, including metatarsal osteotomies and adjacent nerve exploration, with resultant fat pad atrophy and chronic metatarsalgia...
November 1984: Orthopedics
Nicholas Russell, Peter Stavrou, George Dracopoulos
No abstract text is available yet for this article.
April 2014: ANZ Journal of Surgery
Sameer Jain, Ken Mannan
Morton's neuroma is a common condition mainly affecting middle aged women, and there are many proposed etiological theories involving chronic repetitive trauma, ischemia, entrapment, and intermetatarsal bursitis. Incorrect terminology suggests that the underlying pathological process is a nerve tumor, although histological examination reveals the presence of inflammatory tissue-that is, perineural fibrosis. The common digital nerve and its branches in the third planter webspace are most commonly affected. Diagnosis is usually made through history taking and clinical examination but may be aided by ultrasonography and magnetic resonance imaging...
August 2013: Foot & Ankle Specialist
Matrona Giakoumis, Jay D Ryan, Jigna Jani
BACKGROUND: The present study was conducted in an attempt to obtain consistent similarities among histologic findings of surgically excised neuromas. Secondly, we looked for a correlation between the presence of a neuroma with certain comorbidities. METHODS: A total of 22 specimens with a preoperative diagnosis of Morton's neuroma were sent to the pathology laboratory, and evaluation was performed by a single pathologist. RESULTS: Degenerative changes were seen in 59% of the specimens...
May 2013: Journal of the American Podiatric Medical Association
Cristina Hernández-Díaz, Miguel Ángel Saavedra, José Eduardo Navarro-Zarza, Juan J Canoso, Pablo Villaseñor-Ovies, Angélica Vargas, Robert A Kalish
This paper emphasizes the anatomical substrate of several foot conditions that are seldom discussed in this context. These include the insertional and non-insertional Achilles tendinopathies, plantar fasciopathy, inferior and posterior heel spurs, foot compartment syndromes, intermetatarsal bursitis and Morton's neuroma. It is a rather superficial anatomical review of an organ that remains largely neglected by rheumatologists. It is our hope that the cases discussed and the cross examination by instructors and participants will stimulate study of the foot and the attention it deserves...
December 2012: Reumatología Clinica
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