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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 5/2010

01-05-2010 | Ankle

Surgical approaches to the forefoot for common sports-related pathologies: a review of the literature and cadaveric dissection

Authors: David Ahearne, Peter Rosenfeld

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2010

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Abstract

This article reviews the published literature regarding the surgical approaches to pathologies encountered within the forefoot, including arthroscopic and open techniques, and their treatment. We have demonstrated these surgical approaches with cadavers, to identify the key anatomical landmarks and safe zones for these surgical techniques, to prevent the complications associated with their treatment.
Literature
1.
go back to reference Addante JB, Peicott PS, Wong KY, Brooks DL (1986) Interdigital neuromas. Results of surgical excision of 152 neuromas. J Am Podiatr Med Assoc 76(9):493–495PubMed Addante JB, Peicott PS, Wong KY, Brooks DL (1986) Interdigital neuromas. Results of surgical excision of 152 neuromas. J Am Podiatr Med Assoc 76(9):493–495PubMed
2.
go back to reference Aper RL, Saltzman CL, Brown TD (1996) The effect of hallux sesamoid excision on the flexor hallucis longus moment arm. Clin Orthop Relat Res 325:209–217 Aper RL, Saltzman CL, Brown TD (1996) The effect of hallux sesamoid excision on the flexor hallucis longus moment arm. Clin Orthop Relat Res 325:209–217
3.
go back to reference Barrett SL, Pignetti TT (1994) Endoscopic decompression for intermetatarsal nerve entrapment—the EDIN technique: preliminary study with cadaveric specimens; early clinical results. J Foot Ankle Surg 33(5):503–508PubMed Barrett SL, Pignetti TT (1994) Endoscopic decompression for intermetatarsal nerve entrapment—the EDIN technique: preliminary study with cadaveric specimens; early clinical results. J Foot Ankle Surg 33(5):503–508PubMed
4.
go back to reference Barrett SL, Walsh AS (2006) Endoscopic decompression of intermetatarsal nerve entrapment: a retrospective study. J Am Podiatr Med Assoc 96(1):19–23PubMed Barrett SL, Walsh AS (2006) Endoscopic decompression of intermetatarsal nerve entrapment: a retrospective study. J Am Podiatr Med Assoc 96(1):19–23PubMed
5.
go back to reference Bartlett DH (1988) Arthroscopic management of osteochondritis dissecans of the first metatarsal head. Arthroscopy 4(1):51–54PubMed Bartlett DH (1988) Arthroscopic management of osteochondritis dissecans of the first metatarsal head. Arthroscopy 4(1):51–54PubMed
6.
go back to reference Bartolomei FJ, Wertheimer SJ (1983) Intermetatarsal neuromas: distribution and etiologic factors. J Foot Surg 22(4):279–282PubMed Bartolomei FJ, Wertheimer SJ (1983) Intermetatarsal neuromas: distribution and etiologic factors. J Foot Surg 22(4):279–282PubMed
7.
go back to reference Coughlin MJ, Pinsonneault T (2001) Operative treatment of interdigital neuroma. A long-term follow-up study. J Bone Joint Surg Am 83-A(9):1321–1328 Coughlin MJ, Pinsonneault T (2001) Operative treatment of interdigital neuroma. A long-term follow-up study. J Bone Joint Surg Am 83-A(9):1321–1328
8.
go back to reference Davies MS, Saxby TS (1999) Arthroscopy of the first metatarsophalangeal joint. J Bone Joint Surg Br 81(2):203–206CrossRefPubMed Davies MS, Saxby TS (1999) Arthroscopy of the first metatarsophalangeal joint. J Bone Joint Surg Br 81(2):203–206CrossRefPubMed
9.
go back to reference Davies MS, Saxby TS (2000) Arthroscopy of the hallux metatarsophalangeal joint. Foot Ankle Clin 5(3):715–724PubMed Davies MS, Saxby TS (2000) Arthroscopy of the hallux metatarsophalangeal joint. Foot Ankle Clin 5(3):715–724PubMed
10.
go back to reference Debnath UK, Hemmady MV, Hariharan K (2006) Indications for and technique of first metatarsophalangeal joint arthroscopy. Foot Ankle Int 27(12):1049–1054PubMed Debnath UK, Hemmady MV, Hariharan K (2006) Indications for and technique of first metatarsophalangeal joint arthroscopy. Foot Ankle Int 27(12):1049–1054PubMed
11.
go back to reference Dedmond BT, Cory JW, McBryde A Jr (2006) The hallucal sesamoid complex. J Am Acad Orthop Surg 14(13):745–753PubMed Dedmond BT, Cory JW, McBryde A Jr (2006) The hallucal sesamoid complex. J Am Acad Orthop Surg 14(13):745–753PubMed
12.
go back to reference Dereymaeker G, Schroven I, Steenwerckx A, Stuer P (1996) Results of excision of the interdigital nerve in the treatment of Morton’s metatarsalgia. Acta Orthop Belg 62(1):22–25PubMed Dereymaeker G, Schroven I, Steenwerckx A, Stuer P (1996) Results of excision of the interdigital nerve in the treatment of Morton’s metatarsalgia. Acta Orthop Belg 62(1):22–25PubMed
13.
go back to reference Ferkel RD, Small HN, Gittins JE (2001) Complications in foot and ankle arthroscopy. Clin Orthop Relat Res 391:89–104 Ferkel RD, Small HN, Gittins JE (2001) Complications in foot and ankle arthroscopy. Clin Orthop Relat Res 391:89–104
14.
go back to reference Friscia DA, Strom DE, Parr JW, Saltzman CL, Johnson KA (1991) Surgical treatment for primary interdigital neuroma. Orthopedics 14(6):669–672PubMed Friscia DA, Strom DE, Parr JW, Saltzman CL, Johnson KA (1991) Surgical treatment for primary interdigital neuroma. Orthopedics 14(6):669–672PubMed
15.
go back to reference Gauthier G (1979) Thomas Morton’s disease: a nerve entrapment syndrome. A new surgical technique. Clin Orthop Relat Res 142:90–92 Gauthier G (1979) Thomas Morton’s disease: a nerve entrapment syndrome. A new surgical technique. Clin Orthop Relat Res 142:90–92
16.
go back to reference Gaynor R, Hake D, Spinner SM, Tomczak RL (1989) A comparative analysis of conservative versus surgical treatment of Morton’s neuroma. J Am Podiatr Med Assoc 79(1):27–30PubMed Gaynor R, Hake D, Spinner SM, Tomczak RL (1989) A comparative analysis of conservative versus surgical treatment of Morton’s neuroma. J Am Podiatr Med Assoc 79(1):27–30PubMed
17.
go back to reference Giannini S, Bacchini P, Ceccarelli F, Vannini F (2004) Interdigital neuroma: clinical examination and histopathologic results in 63 cases treated with excision. Foot Ankle Int 25(2):79–84PubMed Giannini S, Bacchini P, Ceccarelli F, Vannini F (2004) Interdigital neuroma: clinical examination and histopathologic results in 63 cases treated with excision. Foot Ankle Int 25(2):79–84PubMed
18.
go back to reference Graham CE, Graham DM (1984) Morton’s neuroma: a microscopic evaluation. Foot Ankle 5(3):150–153PubMed Graham CE, Graham DM (1984) Morton’s neuroma: a microscopic evaluation. Foot Ankle 5(3):150–153PubMed
19.
go back to reference Ha’Eri GB, Fornasier VL, Schatzker J (1979) Morton’s neuroma—pathogenesis and ultrastructure. Clin Orthop Relat Res 141:256–259 Ha’Eri GB, Fornasier VL, Schatzker J (1979) Morton’s neuroma—pathogenesis and ultrastructure. Clin Orthop Relat Res 141:256–259
20.
go back to reference Kim JY, Choi JH, Park J, Wang J, Lee I (2007) An anatomical study of Morton’s interdigital neuroma: the relationship between the occurring site and the deep transverse metatarsal ligament (DTML). Foot Ankle Int 28(9):1007–1010CrossRefPubMed Kim JY, Choi JH, Park J, Wang J, Lee I (2007) An anatomical study of Morton’s interdigital neuroma: the relationship between the occurring site and the deep transverse metatarsal ligament (DTML). Foot Ankle Int 28(9):1007–1010CrossRefPubMed
21.
go back to reference Leventen EO (1991) Sesamoid disorders and treatment. An update. Clin Orthop Relat Res 269:236–240 Leventen EO (1991) Sesamoid disorders and treatment. An update. Clin Orthop Relat Res 269:236–240
22.
go back to reference Levitsky KA, Alman BA, Jevsevar DS, Morehead J (1993) Digital nerves of the foot: anatomic variations and implications regarding the pathogenesis of interdigital neuroma. Foot Ankle 14(4):208–214PubMed Levitsky KA, Alman BA, Jevsevar DS, Morehead J (1993) Digital nerves of the foot: anatomic variations and implications regarding the pathogenesis of interdigital neuroma. Foot Ankle 14(4):208–214PubMed
23.
go back to reference Lui TH (2008) First metatarsophalangeal joint arthroscopy in patients with hallux valgus. Arthroscopy 24(10):1122–1129PubMedCrossRef Lui TH (2008) First metatarsophalangeal joint arthroscopy in patients with hallux valgus. Arthroscopy 24(10):1122–1129PubMedCrossRef
24.
go back to reference Nashi M, Venkatachalam AK, Muddu BN (1997) Surgery of Morton’s neuroma: dorsal or plantar approach? J R Coll Surg Edinb 42(1):36–37PubMed Nashi M, Venkatachalam AK, Muddu BN (1997) Surgery of Morton’s neuroma: dorsal or plantar approach? J R Coll Surg Edinb 42(1):36–37PubMed
25.
go back to reference Nemoto K, Mikasa M, Tazaki K, Mori Y (1989) Neurolysis as a surgical procedure for Morton’s neuroma. Nippon Seikeigeka Gakkai Zasshi 63(5):470–474PubMed Nemoto K, Mikasa M, Tazaki K, Mori Y (1989) Neurolysis as a surgical procedure for Morton’s neuroma. Nippon Seikeigeka Gakkai Zasshi 63(5):470–474PubMed
26.
go back to reference Ozkoc G, Akpinar S, Ozalay M, Hersekli MA, Pourbagher A, Kayaselcuk F, Tandogan RN (2005) Hallucal sesamoid osteonecrosis: an overlooked cause of forefoot pain. J Am Podiatr Med Assoc 95(3):277–280PubMed Ozkoc G, Akpinar S, Ozalay M, Hersekli MA, Pourbagher A, Kayaselcuk F, Tandogan RN (2005) Hallucal sesamoid osteonecrosis: an overlooked cause of forefoot pain. J Am Podiatr Med Assoc 95(3):277–280PubMed
27.
go back to reference Pretterklieber ML, Wanivenhaus A (1992) The arterial supply of the sesamoid bones of the hallux: the course and source of the nutrient arteries as an anatomical basis for surgical approaches to the great toe. Foot Ankle 13(1):27–31PubMed Pretterklieber ML, Wanivenhaus A (1992) The arterial supply of the sesamoid bones of the hallux: the course and source of the nutrient arteries as an anatomical basis for surgical approaches to the great toe. Foot Ankle 13(1):27–31PubMed
28.
go back to reference Rath B, Notermans HP, Frank D, Walpert J, Deschner J, Luering CM, Koeck FX, Koebke J (2009) Arterial anatomy of the hallucal sesamoids. Clin Anat 22(6):755–760CrossRefPubMed Rath B, Notermans HP, Frank D, Walpert J, Deschner J, Luering CM, Koeck FX, Koebke J (2009) Arterial anatomy of the hallucal sesamoids. Clin Anat 22(6):755–760CrossRefPubMed
29.
go back to reference Richardson EG (1999) Hallucal sesamoid pain: causes and surgical treatment. J Am Acad Orthop Surg 7(4):270–278PubMed Richardson EG (1999) Hallucal sesamoid pain: causes and surgical treatment. J Am Acad Orthop Surg 7(4):270–278PubMed
30.
go back to reference Richardson EG, Brotzman SB, Graves SC (1993) The plantar incision for procedures involving the forefoot. An evaluation of one hundred and fifty incisions in one hundred and fifteen patients. J Bone Joint Surg Am 75(5):726–731PubMed Richardson EG, Brotzman SB, Graves SC (1993) The plantar incision for procedures involving the forefoot. An evaluation of one hundred and fifty incisions in one hundred and fifteen patients. J Bone Joint Surg Am 75(5):726–731PubMed
31.
go back to reference Ruuskanen MM, Niinimaki T, Jalovaara P (1994) Results of the surgical treatment of Morton’s neuralgia in 58 operated intermetatarsal spaces followed over 6 (2–12) years. Arch Orthop Trauma Surg 113(2):78–80CrossRefPubMed Ruuskanen MM, Niinimaki T, Jalovaara P (1994) Results of the surgical treatment of Morton’s neuralgia in 58 operated intermetatarsal spaces followed over 6 (2–12) years. Arch Orthop Trauma Surg 113(2):78–80CrossRefPubMed
32.
go back to reference Saxena A, Krisdakumtorn T (2003) Return to activity after sesamoidectomy in athletically active individuals. Foot Ankle Int 24(5):415–419PubMed Saxena A, Krisdakumtorn T (2003) Return to activity after sesamoidectomy in athletically active individuals. Foot Ankle Int 24(5):415–419PubMed
33.
go back to reference Shapiro SL (2004) Endoscopic decompression of the intermetatarsal nerve for Morton’s neuroma. Foot Ankle Clin 9(2):297–304CrossRefPubMed Shapiro SL (2004) Endoscopic decompression of the intermetatarsal nerve for Morton’s neuroma. Foot Ankle Clin 9(2):297–304CrossRefPubMed
34.
go back to reference Shonka TE (1991) Metatarsal phalangeal joint arthroscopy. J Foot Surg 30(1):26–28PubMed Shonka TE (1991) Metatarsal phalangeal joint arthroscopy. J Foot Surg 30(1):26–28PubMed
35.
go back to reference Thomson CE, Gibson JN, Martin D (2004) Interventions for the treatment of Morton’s neuroma. Cochrane Database Syst Rev(3):CD003118 Thomson CE, Gibson JN, Martin D (2004) Interventions for the treatment of Morton’s neuroma. Cochrane Database Syst Rev(3):CD003118
36.
go back to reference Valente M, Crucil M, Alecci V (2008) Operative treatment of interdigital Morton’s neuroma. Chir Organi Mov 92(1):39–43CrossRefPubMed Valente M, Crucil M, Alecci V (2008) Operative treatment of interdigital Morton’s neuroma. Chir Organi Mov 92(1):39–43CrossRefPubMed
37.
go back to reference van Dijk CN, Veenstra KM, Nuesch BC (1998) Arthroscopic surgery of the metatarsophalangeal first joint. Arthroscopy 14(8):851–855PubMed van Dijk CN, Veenstra KM, Nuesch BC (1998) Arthroscopic surgery of the metatarsophalangeal first joint. Arthroscopy 14(8):851–855PubMed
39.
go back to reference Zelent ME, Kane RM, Neese DJ, Lockner WB (2007) Minimally invasive Morton’s intermetatarsal neuroma decompression. Foot Ankle Int 28(2):263–265CrossRefPubMed Zelent ME, Kane RM, Neese DJ, Lockner WB (2007) Minimally invasive Morton’s intermetatarsal neuroma decompression. Foot Ankle Int 28(2):263–265CrossRefPubMed
Metadata
Title
Surgical approaches to the forefoot for common sports-related pathologies: a review of the literature and cadaveric dissection
Authors
David Ahearne
Peter Rosenfeld
Publication date
01-05-2010
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2010
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-010-1096-2

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