Neurectomy versus Neurolysis for Morton's Neuroma

Abstract

Background: We evaluated a series of patients who underwent neurectomy or neurolysis for the surgical treatment of Morton's neuroma. Materials and Methods: A group of 50 patients (69 feet) who underwent surgery for a symptomatic Morton's neuroma were retrospectively reviewed. Surgery was performed through a dorsal approach in all cases. When the nerve showed macroscopic thickening or the typical pseudoneuroma, it was resected; when the nerve had no macroscopic changes, the intermetatarsal ligament and any other potentially compressive structure were released. In 17 cases, adjacent claw toes were treated. Results: Nerve thickening (pseudoneuroma) were resected in 46 cases; in the other 23 cases, the nerve was preserved. Total relief from digital nerve related symptoms was obtained in all cases but one in each group. These patients were reoperated on 6 months later by performing a neurectomy in the case where the nerve had been preserved, and a more proximal resection in the case in which the nerve had been resected. Both patients finally achieved complete pain relief. Conclusion: When treating Morton's neuromas surgically, neurolysis can be a valid option when a pseudoneuroma has not developed.