Isolated Intermetatarsal Ligament Release as Primary Operative Management for Morton’s Neuroma: Short-term Results

• Published in: Foot and ankle specialist 2022-08, Vol.15 (4), p.338-345
• Main Authors: Elghazy, Mohamed Abdelaziz, Whitelaw, Kathryn C., Waryasz, Gregory R., Guss, Daniel, Johnson, Anne H., DiGiovanni, Christopher W.
• Format: Article
• Language: English
• ISSN: 1938-6400; 1938-7636
• DOI: 10.1177/1938640020957851

Background Although the precise pathoetiology of Morton’s neuroma remains unclear, chronic nerve entrapment from the overlying intermetatarsal ligament (IML) may play a role. Traditional operative management entails neuroma excision but risks unpredictable formation of stump neuroma. Materials and methods Medical records were examined for adult patients who failed at least 3 months of conservative treatment for symptomatic and recalcitrant Morton’s neuroma and who then underwent isolated IML decompression without neuroma resection. Results A total of 12 patients underwent isolated IML decompression for Morton’s neuroma with an average follow-up of 13.5 months. Visual Analog Pain Scale averaged 6.4 ± 1.8 (4-9) preoperatively and decreased to an average of 2 ± 2.1 (0-7) at final follow-up (P = .002). All patients reported significant improvement. Conclusion Isolated IML release of chronically symptomatic Morton’s neuroma shows promising short-term results regarding pain relief, with no demonstrated risk of recurrent neuroma formation, permanent numbness, or postoperative symptom exacerbation. Level of Evidence: Level IV: Case series