Minimally Invasive Morton's Intermetatarsal Neuroma Decompression

Abstract

Background: We present the results of an alternative technique for decompression of a Morton intermetatarsal neuroma that is minimally invasive and does not require endoscopic instrumentation. Methods: Seventeen nerve decompressions were performed in 14 patients using an instrument designed to release the transverse carpal ligament for carpal tunnel syndrome. Nine women and five men (3 bilateral) had the procedure performed. The mean followup for the 17 decompression procedures was 25.92 months. Results: Eleven of the 14 patients had absence of the neuroma symptoms after the decompression. Two patients had recurrence of symptoms; the third had sustained a crush injury to the operated foot. Both patients with recurrence required revision surgery because the initial procedure failed to relieve symptoms. One patient noted lack of relief in the immediate postoperative period (2 weeks), the other was symptom free for approximately 1 year. Only one of these individuals responded to resection of the intermetatarsal nerve, while the other continues to have pain. There were no wound healing complications or complications related to digital deformity after the procedure. Conclusions: The technique is simple, the postoperative morbidity to the patient is minimal, and the results in this limited number of patients was encouraging.