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BMC Musculoskeletal Disorders

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Open Access 01-12-2022 | Research

Plantar and dorsal approaches for excision of morton’s neuroma: a comparison study

Authors: Wenpeng Xu, Ning Zhang, Zhengxun Li, Yifan Wang, Xiucun Li, Yang Wang, Haipeng Si, Yong Hu

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Abstract

Background

Morton’s neuroma is a painful enlargement of the plantar digital nerve between the metatarsal heads that causes pain of the forefoot. Several approaches have been used to treat Morton’s neuroma, each of them having distinct advantages and disadvantages.

Objectives

The purpose of this study was to investigate and compare the clinical outcomes of neurectomy in the treatment of Morton’s neuroma through plantar and dorsal approaches.

Materials and methods

A total of 20 patients with a mean age of 48.5 ± 13.0 years (range: 19–66 years) who underwent excision of a Morton’s neuroma that did not respond to conservative treatment were retrospectively analysed from June 2014 to June 2021. All the neurectomies were performed using a plantar or dorsal approach. Outcomes were evaluated using visual analogue scale (VAS) scores, American Orthopedic Foot and Ankle Society (AOFAS) scores, the Foot and Ankle Ability Measure (FAAM), and complications. The appearance index (AI) was also used to assess the influence of foot appearance on the quality of life after surgery.

Results

Eight patients underwent neurectomy by the dorsal approach, and 12 patients underwent neurectomy by the plantar approach. The average follow-up time was 28.9 ± 12.9 months (range: 15–72 months). No statistically significant difference was found between the dorsal and plantar approach groups with respect to postoperative pain measured by the VAS score. The postoperative AOFAS scores and FAAM outcomes were not significantly different between the groups. The complications reported in the dorsal approach group were significantly less than those of the plantar group, mainly discomfort in wearing shoes. The AI of the plantar group and the dorsal group were significantly different.

Conclusion

The excision of the Morton’s neuroma by both the dorsal and plantar approach resulted in satisfactory outcomes. However, the foot appearance after surgery by the plantar approach had less influence on the quality of life than that using the dorsal approach. Our recommendation is that surgeons should choose the approach they are most familiar with and with which they are most confident in performing. In addition, the plantar approach is recommended if the patient needs a better appearance.

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Title: Plantar and dorsal approaches for excision of morton’s neuroma: a comparison study
Authors: Wenpeng Xu
Ning Zhang
Zhengxun Li
Yifan Wang
Xiucun Li
Yang Wang
Haipeng Si
Yong Hu
Publication date: 01-12-2022
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-022-05858-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Plantar and dorsal approaches for excision of morton’s neuroma: a comparison study

Abstract

Background

Objectives

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objectives

Materials and methods

Results

Conclusion

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