Minimally Invasive Intermetatarsal Nerve Decompression for Morton's Neuroma: A Review of 27 Cases |
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| Affiliation: | 1. Podiatric Medical Student, California School of Podiatric Medicine, Oakland, CA;2. Senior Data Consultant, Biostatistical Consulting Unit, Kaiser Permanente Division of Research, Oakland, CA;3. Podiatric Surgical Fellow, Palo Alto Medical Foundation, Mountain View, CA;4. Senior Research Project Manager, Department of Graduate Medical Education, Kaiser Permanente Oakland Medical Center, Oakland, CA;5. Research Director and Surgeon, Department of Podiatric Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA;1. Clinical Professor, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA;2. Student, Temple University School of Podiatric Medicine, Philadelphia, PA;1. Specialist Trainee Registrar, Foot and Ankle Division, Orthopaedic Department, Queen Elizabeth University Hospital, Glasgow, United Kingdom;2. Consultant Orthopaedic Foot and Ankle Surgeon, Foot and Ankle Division, Orthopaedic Department, Queen Elizabeth University Hospital, Glasgow, United Kingdom;1. Surgeon, Department of Sports Medicine Shenzhen Hospital of Peking University, Shenzhen, Guangdong, China;2. Associated Professor, Department of Radiology Shenzhen Hospital of Peking University, Shenzhen, Guangdong, China;3. Resident, Department of Sports Medicine Shenzhen Hospital of Peking University, Shenzhen, Guangdong, China;4. Associated Professor, Department of Rehabilitation Shenzhen Hospital of Peking University, Shenzhen, Guangdong, China;5. Doctor, Department of Radiology Shenzhen Hospital of Peking University, Shenzhen, Guangdong, China;6. Professor, Department of Sports Medicine Shenzhen Hospital of Peking University, Shenzhen, Guangdong, China |
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| Abstract: | Minimally invasive nerve decompression for operative management of Morton's neuroma has been shown to be an effective alternative to neurectomy; however, little is known about postoperative outcomes. In this retrospective case series, we reviewed 27 procedures in 25 patients who underwent minimally invasive nerve decompression as primary surgical management for Morton's neuroma. Most subjects (22, or 88%) had 12 or more months of health plan enrollment postoperatively; 3 (12%) had 4 to 7 months of enrollment after the procedure. Postoperative patient satisfaction, complications and the need for a follow-up neurectomy were ascertained from medical record review. Additionally, demographic and clinical data were extracted from electronic sources. Patient satisfaction was unknown for 5 (18.5%) of the 27 procedures. Among the 22 (81.5%) procedures for which there were valid patient satisfaction data, patient satisfaction was excellent for 11 (50%); good for 2 (9.1%), and poor for 9 (40.9%). During the follow-up period, 5 (18.5%) patients required an open neurectomy. Among the 6 (22.2%) patients who presented without a Mulder's sign on physical exam preoperatively, 83% reported excellent results. Minimally invasive nerve decompression may not be as effective as previously seen; however, it may be indicated in patients presenting with absence of a Mulder's sign, a physically small or nascent neuroma. |
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