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 Morton's Neuroma Surgery



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Morton's Neuroma Surgery

Morton's Neuroma is a common foot condition caused by the irritation of the common intermetatarsal nerve as it passes through the forefoot to the toes.

Tight shoes will contribute to the symptoms of Morton's Neuroma by binding the forefoot and compressing the nerve. Higher heels will also act to increase the ground reactive forces. Certain activities, such as squatting, will also increase the force applied to the plantar foot and aggregate the symptoms of Morton's Neuroma.

In the past we knew that the traditional Morton's Neuroma surgery used to treat Morton's Neuroma, called a neurectomy, was destructive and carried a fair amount of post-op complications. Therefore, we would tend to use excessive amounts of cortisone as our only method of treatment. (Which has got its side effects.)

Although Morton's Neuroma surgery is the quickiest to solve the underlying problem, not all Morton's Neuroma requires surgical correction. 50% or more of new Morton's Neuroma patients respond to simple changes in shoes such as a wider toe box. Shoe padding can also help treat Morton's Neuroma.

Only when conservative treatment does not work a Morton's Neuroma surgery will be necessary. Two surgical procedures are available. The dorsal approach involves making an incision on the top of the foot. This approach permits the patient to walk soon after surgery because the stitches are not on the weight-bearing side of the foot.

The podiatrist maneuvers the instruments carefully through many structures and cuts the deep transverse metatarsal ligament, which typically causes most of the nerve compression. This procedure can lead to instability in the forefoot that may require attention in the future.

The second procedure involves a plantar approach, in which the incision is made on the sole of the foot. The patient must use crutches for about 3 weeks and the scar that forms can make walking uncomfortable. The advantage of the plantar approach is that the neuroma can be reached easily and resected without cutting any structures.

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