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Interdigital neuroma

V Bucknall, D Rutherford, D MacDonald, H Shalaby, J McKinley, S J Breusch
AIMS: This is the first prospective study to report the pre- and post-operative patient reported outcomes and satisfaction scores following excision of interdigital Morton's neuroma. PATIENTS AND METHODS: Between May 2006 and April 2013, we prospectively studied 99 consecutive patients (111 feet) who were to undergo excision of a Morton's neuroma. There were 78 women and 21 men with a mean age at the time of surgery of 56 years (22 to 78). Patients completed the Manchester-Oxford Foot Questionnaire (MOXFQ), Short Form-12 (SF-12) and a supplementary patient satisfaction survey three months pre-operatively and six months post-operatively...
October 2016: Bone & Joint Journal
Jeffrey A Strakowski
Ultrasound guidance allows real-time visualization of the needle in peripheral nerve procedures, improving accuracy and safety. Sonographic visualization of the peripheral nerve and surrounding anatomy can provide valuable information for diagnostic purposes and procedure enhancement. Common procedures discussed are the suprascapular nerve at the suprascapular notch, deep branch of the radial nerve at the supinator, median nerve at the pronator teres and carpal tunnel, lateral cutaneous nerve of the thigh, superficial fibular nerve at the leg, tibial nerve at the ankle, and interdigital neuroma...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
Charles Yang, Elaine S Gould, Maryanna Mason
We present the case of a 20-year-old man with the chief complaint of right foot pain for the past three years presenting with focal bony prominence at dorsomedial aspect of right mid foot with interdigital pain. MRI demonstrated a metatarsal coalition with interdigital neuroma.
2009: Radiology case reports
Stefan N van Vendeloo, Harmen B Ettema
Steroid injection is frequently used in the treatment of interdigital neuroma and has a high rate of success. We report the case of a patient who develops skin depigmentation at the injection site and linear streaks of depigmentation over the foot, the ankle and half way up to the knee after a steroid injection for interdigital neuroma. Minor disadvantages such as subcutaneous fat atrophy and depigmentation of the skin at the injection site are well known problems following steroid injection. Depigmentation of the skin with a lymphatic distribution in the foot after steroid injection for interdigital neuroma however, has not yet been reported before...
June 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
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
Ayşe Merve Ata, Şule Şahin Onat, Levent Özçakar
Morton's neuroma is the fibrous enlargement of the interdigital nerve branches, usually in the second and third interspace between the metatarsal heads where the lateral and medial plantar nerves often join. Specific symptoms are dull or sharp pain, numbness and/or tingling in the third and fourth digits, burning sensation, cramping, and a feeling of "walking on a stone" around the metatarsal heads. Numerous clinical tests for Morton's neuroma have been described, such as thumb index finger squeeze, and Mulder's click and foot squeeze tests...
February 2016: Pain Physician
Kathryn M O'Connor, Jeffrey E Johnson, Jeremy J McCormick, Sandra E Klein
BACKGROUND: Diagnosis of an interdigital neuroma (IDN) is clinically based on patient symptoms. During operative excision, it is common to send the excised specimen for routine histopathologic examination. The purpose of this study was to evaluate the accuracy of the clinical and intraoperative diagnosis of IDN and correlate these with the histopathologic results of IDN. METHODS: Case logs of 3 fellowship-trained foot and ankle surgeons were reviewed to identify all neuroma excisions completed between 1997 and 2014...
January 2016: Foot & Ankle International
Chamnanni Rungprai, Christopher C Cychosz, Ongart Phruetthiphat, John E Femino, Annunziato Amendola, Phinit Phisitkul
BACKGROUND: Simple neurectomy is a standard treatment of interdigital nerve neuroma after failure of conservative treatment. Recently, neurectomy with intramuscular implantation of the proximal nerve stump has been proposed as a safe and effective alternative method providing significant pain improvement. However, there remains little evidence supporting one technique over the other. The purpose of this study was to compare functional outcomes and complications of simple neurectomy versus neurectomy with intramuscular implantation...
December 2015: Foot & Ankle International
Gordon Lee, Euicheol Jeong
In this report, we present a case of toe reconstruction with a medial sural artery perforator free flap after failure of replantation. A 35-year-old male suffered a crush injury from a heavy object falling over the left 1st, 2nd, and 3rd toes and underwent microsurgical replantation of the toes at an outside facility. Over the next 2 weeks, ischemic necrosis of all the toes developed. This condition was very frustrating for the patient who had very high expectations of preserving the toes, and also for the surgeon to determine the optimal method to reconstruct the distal foot and toes...
February 2016: Microsurgery
Roberto Sergio Martins, Mario Gilberto Siqueira, Carlos Otto Heise, Lin Tchia Yeng, Daniel Ciampi de Andrade, Manoel Jacobsen Teixeira
BACKGROUND: Painful neuroma following amputation is a disabling condition for which treatments are not usually satisfactory. The aim of this study is to retrospectively evaluate the results of interdigital neurorrhaphy after neuroma resection as an option for the surgical treatment of painful digital neuroma. METHOD: We retrospectively analyzed data from seven patients submitted to interdigital neurorrhaphy for treatment of digital neuroma. For evaluation of the results, the visual analog scale (VAS) for pain assessment, measurements with Simmens-Weinstein filaments and a handgrip dynamometer, and quantification of the Disabilities of the Arm, Shoulder and Hand (DASH) score were all performed...
April 2015: Acta Neurochirurgica
Shinji Isomoto, Yasuhito Tanaka
Morton's disease refers to neuralgia at the web space of the toes with a pseudo-neuroma. It commonly occurs in the third web space of the foot in middle-aged and older women. The pseudo-neuroma is thought to be a secondary change after entrapment or repeated microtrauma. Patients complain of forefoot pain while walking. Typically, symptoms are caused by tight high-heeled shoes. The physical examination includes palpation of the web spaces and Mulder's test. Weight bearing foot radiographs are used to evaluate the deformity of the foot, especially at metatarsophalangeal (MTP) joints...
December 2014: Brain and Nerve, Shinkei Kenkyū No Shinpo
David R Richardson, Erin M Dean
Interdigital neuromas are a common cause of forefoot pain, and approximately 80% of patients require surgical excision for symptom relief. Although 50% to 85% of patients obtain relief after primary excision, symptoms may recur because of an incorrect diagnosis, inadequate resection, or adherence of pressure on a nerve stump neuroma. The symptom relief rate after reoperation is similar to that after primary excision. A plantar longitudinal incision provides optimal exposure, and transposition of the nerve stump into bone or muscle and avoids traction or pressure on the nerve ending that can result in a painful stump neuroma...
September 2014: Foot and Ankle Clinics
José Valero, José Gallart, David González, Javier Deus, Manuel Lahoz
Morton's neuroma is a common pathologic entity that, traditionally, was considered to be an isolated tumor that rarely affected more than 1 interdigital space. However, in recent years, multiple neuromas have become more common in our day-to-day practice. The objective of the present study was to assess the frequency with which Morton's neuroma appears in the different interdigital spaces. A retrospective study was performed of 279 feet that had been surgically treated for Morton's neuroma using a dorsal approach during a 9-year period (from January 2003 to December 2011), with an ultrasound scan taken preoperatively and histopathologic analysis performed afterward...
May 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
José Manuel Pardal-Fernández, Elena Palazón-García, Francisco Hernández-Fernández, Carlos de Cabo
BACKGROUND: Morton's neuroma causes metatarsalgia due to the interdigital neuropathy. The small nerve diameter compromises their evaluation in image studies. To overcome this problem we propose a new electrophysiological test. METHODS: We conducted a prospective case-control study performing a orthodromic electroneurography using subdermal electrodes in controls and patients to assess the validity. Additionally all patients were tested with magnetic resonance. Some patients required surgery and subsequent histological evaluation...
June 2014: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Shinichi Abe, Tadashi Nakao, Shigeki Yamane, Masayuki Fukuda, Masahito Yamamoto, Risto Santti, Gen Murakami
To examine morphological differences in Morton's interdigital neuroma between two elderly human populations, we conducted comparative study using 40 Japanese (27 males, 13 females; mean age, 81.2 years) and 21 Finnish (6 males, 15 females; mean age, 80.5 years) cadavers. We defined the neuroma as a thickening of the nerve of at least two-fold relative to the non-pathological proximal part. The incidence of this neuroma was 25% (10/40) in the Japanese and 33.3% (7/21) in the Finnish cadavers. Moderate or severe hallux valgus (with an angle of more than 20 degrees) was seen in half of the 40 Japanese cadavers (7 males, 13 females), but was absent in the Finnish cadavers...
2013: Okajimas Folia Anatomica Japonica
Maximilian Kasparek, Wolfgang Schneider
PURPOSE: Long-term results following surgical treatment of Morton neuroma are rare. The purpose of the present study was to evaluate patients after excision of Morton's neuroma at least ten years following surgery. METHODS: We performed a retrospective review of the patients' records who underwent excision of an interdigital neuroma with the clinical diagnosis of Morton's neuroma. Eighty-one patients who had undergone surgery on 98 feet were analysed at an average of 15...
September 2013: International Orthopaedics
Elif Ilgaz Aydinlar, Metin Uzun, Burak Beksac, Vahit Emre Ozden, Ercan Karaarslan, A Emre Oge
INTRODUCTION: We describe a simple and quickly applied electrodiagnostic method for confirming the diagnosis of interdigital neuropathy caused by Morton neuroma (MN). METHODS: Interdigital nerves II-III and III-IV were stimulated with surface electrodes simultaneously touching the lateral side of 1 toe and the medial side of the other. Recording was also made with surface electrodes. The results of 20 normal controls and 14 patients with MN were evaluated. RESULTS: The amplitude and peak latency values elicited in the patients as well as the interside differences revealed an acceptable abnormality rate between 57...
February 2014: Muscle & Nerve
W Chad Hembree, Adam T Groth, Lew C Schon, Gregory P Guyton
BACKGROUND: Injection for interdigital neuroma (IDN) may not selectively target the common digital nerve. We investigated the anatomical localization and extent of extravasation with injection for IDN. METHODS: Two fellowship-trained foot and ankle surgeons injected radiopaque contrast into the third webspace of 49 cadaveric specimens (29 with 2 mL and 20 with 1 mL). Computed tomography scan of each specimen was obtained. An independent blinded foot and ankle surgeon analyzed the scans...
April 2013: Foot & Ankle International
Graham S J Chuter, Yeok Pin Chua, David A Connell, Mark C Blackney
OBJECTIVE: To identify the benefits of ultrasound-guided radiofrequency ablation of Morton's neuroma as an alternative to surgical excision. MATERIALS AND METHODS: We studied a consecutive cohort of surgical candidates for Morton's neurectomy who we referred, instead, for radiofrequency ablation (RFA). Under local anaesthetic, RFA was performed under ultrasound guidance, by a single radiologist. This out-patient procedure was repeated after 4 weeks if necessary...
January 2013: Skeletal Radiology
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