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Background. The urgency of the problem is explained by a high morbidity rate and the need to verify the diagnosis with related specialists (ultrasound physicians, radiologists, trauma surgeons, pathologists), as well as by significant difficulties in patient routing and high probability of primary referral to neurologists, neurosurgeons, and general practitioners. In modern Russian literature, neuromas of all interdigital spaces are identified with Morton’s neuroma. Aim of the review was to determine the accuracy of modern medical terminology, in particular of the term «Morton’s neuroma», to reveal the spectrum of eponyms unacceptable for communication with related specialists and patients, to fill the historical gap and to attract the scientific medical community to discussion on this topic. Methods. We identified 40 articles on this topic published from 1845 to 2022. The search was performed in PubMed/MEDLINE and eLIBRARY databases. Results. Evolution, history, and etymology of several terms used for intermetatarsal neuroma are covered in the study, based on the analysis of literature sources. It has been found that a number of eponyms used to designate neuromas are historically inaccurate. In addition, we have discovered that the reports of «nerve fibrosis» were encountered prior to the introduction of the term «neuroma». However, most authors have popularized the nominal term «Morton’s neuromas». Conclusions. An obvious contradiction between the etiopathogenesis of neuroma and the term itself can be confusing for clinicians and diagnosticians. In our opinion, the disease known nowadays as «Morton’s neuroma» should be named «fibrosis of the plantar nerve of the third toe», and the name terms denoting the number of the corresponding interdigital space should be replaced by the number of the corresponding common plantar digital nerve.

Background: Surgical treatment of Morton's neuroma remains controversial. Several surgical techniques have been described including percutaneous transection of the deep metatarsal transverse ligament (DMTL).Purpose: To evaluate the efficacy and safety of percutaneous release of the DMTL under ultrasound guidance for the treatment of Morton's syndrome.Materials and Methodology: Percutaneous release of the DMTL was performed with ultrasound guidance in 48 intermetatarsal spaces of 16 cadaveric specimens. Specimens were then dissected to assess the completion of the release and the presence of any injuries of the neurovascular and tendinous adjacent structures.Results: The DMTL was visualized with ultrasound in all cases. Complete release of the ligament was achieved in 87.5% (42/48) cases. One case of interdigital nerve injury was found.Conclusion: Percutaneous release of DMTL with ultrasound guidance for the treatment of Morton's disease has an acceptable rate of complications but care must be taken to ensure the complete release of the ligament. [ABSTRACT FROM AUTHOR]

Myriad pathologies affect the lesser toes. In this article, the focus is on the challenging radiological differential diagnosis of plantar plate (PP) degeneration and tear versus webspace neuroma. It is now understood that PP tear and even degeneration without tear is most accompanied by reactive pericapsular soft tissue thickening (pseudoneuroma), which contributes to neuritic symptoms that are often indistinguishable from webspace neuroma. In this article, the authors will review the differing clinical presentations and radiographic, sonographic, and MRI findings of these entities and the different acquired toe deformities that occur in PP dysfunction with pseudoneuroma, versus webspace neuroma., Competing Interests: Disclosure Authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: The effectiveness of operative treatments other than neurectomy for Morton's neuroma remains debatable despite several reported studies. This review aimed to evaluate the effects of operative treatments for Morton's neuroma other than neurectomy using an algorithmic approach and a structured critical framework to assess the methodological quality of reported studies.Methods: Several electronic databases were searched for articles published until August 2021 that evaluated the outcomes of operative treatments other than neurectomy in patients diagnosed with Morton's neuroma. Data searches, extraction, analysis, and quality assessments were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the clinical outcomes were evaluated using objective, subjective, and negative outcomes; complications; and reoperation rate and type.Results: After reviewing 11,213 studies, 22 studies were finally included. Although a number of studies with high level of evidence are limited, we divided them according to four categories: (1) neurolysis with or without nerve transposition, (2) minimally invasive nerve decompression, (3) metatarsal osteotomy, and (4) additional procedures after nerve transection or neurectomy. All categories showed reliable outcomes except minimally invasive nerve decompression. The proportion of postoperative neurogenic symptoms was lower with neurolysis than with neurectomy.Conclusion: Whether the alternative procedures were superior to neurectomy remains unclear as the number of good quality studies was limited. The proportion of postoperative neurogenic symptoms was lower with neurolysis than with neurectomy. Furthermore, performing simultaneous dorsal transposition of the nerve along with neurolysis is more recommended than neurolysis alone. Surgeons should be more careful with minimally invasive deep transverse intermetatarsal ligament release and metatarsal shortening osteotomy as their effectiveness remains inconclusive. Finally, we strongly recommend performing intramuscular embedding or intermuscular transposition of the nerve cutting end if neurectomy or nerve transection is inevitable.Level Of Evidence: Level III, systematic review. [ABSTRACT FROM AUTHOR]

The optimal treatment strategy for the presentation of multiple Morton's neuromas in adjacent intermetatarsal spaces of the same foot is yet to be determined. We aimed to summarize and assess the efficacy of current treatment strategies. A systematic review, adhering to PRIMSA guidelines was performed. A computer base search was completed in PubMed, Embase, Cinahl, ISI Web of Science, Scopus and Emcare, for articles reporting the treatment of multiple neuromas in the same foot. The review is registered in the international prospective register of systematic reviews (CRD42020213631). A total of 253 articles were identified, with 7 articles being included in the review. The most common treatment strategy reported was simultaneous neuroma excision using a single incision, while 2 studies each describe simultaneous excision with 2 separate incisions and delayed excision respectively. There is no strong evidence favoring use of delayed excision or multiple incisions. Further high-quality research is required to make more definitive conclusions and future research should investigate other strategies such as non-operative treatment. [ABSTRACT FROM AUTHOR]

Background: Individual evidence suggests that multiple modalities can be used to treat entrapment pathology by Morton's neuroma, including injection, neurolysis, and neurectomy. However, their impacts on patient pain and satisfaction have yet to be fully defined or elucidated. Correspondingly, our aim was to pool systematically identified metadata and substantiate the impact of these different modalities in treating Morton's neuroma with respect to these outcomes. Methods: Searches of 7 electronic databases from inception to October 2019 were conducted following PRISMA guidelines. Articles were screened against pre-specified criteria. The incidences of outcomes were extracted and pooled by random-effects meta-analysis of proportions. Results: A total of 35 articles satisfied all criteria, reporting a total of 2998 patients with Morton's neuroma managed by one of the three modalities. Incidence of complete pain relief after injection (43%; 95% CI, 23–64%) was significantly lower than neurolysis (68%; 95% CI, 51–84%) and neurectomy (74%; 95% CI, 66–82%) (P = 0.02). Incidence of complete satisfaction after injection (35%; 95% CI, 21–50%) was significantly lower than neurolysis (63%; 95% CI, 50–74%) and neurectomy (57%; 95% CI, 47–67%) (P < 0.01). The need to proceed to further surgery was significantly greater following injection (15%; 95% CI, 9–23%) versus neurolysis (2%; 95% CI, 0–4%) or neurectomy (5%; 95% CI, 3–7%) (P < 0.01). Incidence of procedural complications did not differ between modalities (P = 0.30). Conclusions: Although all interventions demonstrated favorable procedural complication incidences, surgical interventions by either neurolysis or neurectomy appear to trend towards greater incidences of complete pain relief and complete patient satisfaction outcomes compared to injection treatment. The optimal decision-making algorithm for treatment for Morton's neuroma should incorporate these findings to better form and meet the expectations of patients. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Title: Non-surgical treatment for Morton's neuroma: a systematic review.Background: Morton's neuroma (MN) is an entrapment degenerative neuropathy with a strong predilection for the 3rd interdigital web space. The objective of our study was to identify the most significant evidence produced for the non-operative treatment of Morton's neuroma and assess outcomes of these interventions.Method: The electronic databases Medline, Ovid EMBASE, CINAHL and Cochrane CENTRAL from inception to October 2018 were searched. Two independent reviewers assessed the quality of the studies using the Modified Coleman Criteria. Statistics were combined across cohort studies to calculate pooled mean results, and improvements in outcomes.Results: Initial electronic and hand search identified 486 studies. After title and abstract review there were 38 that went on to full-text review. Finally, 22 studies were included in the final review. We identified 9 different non-operative treatment modalities; Corticosteroid injection, Alcohol injection, Extra-corporeal Shockwave therapy (ESWT), Radiofrequency Ablation (RFA), Cryoablation, Capsaicin injection, Botulinum toxin, Orthosis and YAG Laser Therapy. Corticosteroid showed a statistically significant reduction in mean VAS over all their studies (p < 0.01), with 50% success at 12 months. Alcohol showed promising short-term pain-relieving results only. Orthotics, Capsaicin injections, Cryoablation, Botulinum toxin, RFA and ESWT did show statistically significant improvements, but with limitation to their application.Conclusion: Following review, the authors would recommend the use of corticosteroid injections to treat Morton's neuromas. The authors feel that radio-frequency ablation and cryoablation would benefit from further well designed randomised controlled trials. [ABSTRACT FROM AUTHOR]

Background: Morton's neuroma is a frequent cause of metatarsalgia. Operative treatment is indicated if nonoperative management has failed. The objective of the present study was to describe a technique of Morton's neuroma excision by a minimally invasive commissural approach and evaluate the long-term outcome and complications. Methods: A retrospective study of 108 patients with Morton's neuroma treated surgically with a commissural approach between September 1990 and December 2010 was performed. The surgical technique is described. Clinical outcomes and complications were evaluated. The average follow-up was 121 months. Eleven patients were men and 97 women. The average age was 49.4 years; 56.8% neuromas were at the third space and 43.2% at the second space. Six patients presented 2 neuromas in the same foot, and 9 patients had bilateral neuroma. Results: The visual analog scale (VAS) average pain score was 5.4 points preoperatively and 0.2 points at the final follow-up. The author found a significant difference between the VAS scores preoperatively and postoperatively (P <.01). Excellent and good satisfaction outcomes were achieved in 93.6%. The postoperative complication incidence was 3%. Conclusion: The author believes a minimally invasive commissural approach has advantages over a dorsal or plantar incision. It is a simple and reproducible technique, with satisfactory outcomes, low complication rates, and a quick return to usual activities. Level of Evidence: Level IV, retrospective case series. [ABSTRACT FROM AUTHOR]

Background: Morton's neuroma is a common cause of forefoot pain. Various conservative methods (injections of various pharmacologic agents) have been published with an outcome of 6%-75% success rate (free of pain in daily life) per injection. The aim of the present study was to assess the outcome of an improved localization technique, a higher dosage, and a higher percentage of ethanol. Methods: Using fluoroscopic and electroneurographic guidance, 2.5 mL of 70% ethanol were injected into 33 feet with a magnetic resonance imaging (MRI)–verified neuroma. We evaluated patients at up to 5-year follow-up. Results: A "success rate" of more than 82% per single injection (defined as free of pain in daily life) was achieved and no recurrence was seen over 5 years. All scores (visual analog scale; Short Form–36 subscales, American Orthopaedic Foot & Ankle Society ankle-hindfoot score) showed significant improvement (P <.0001). Mean 1.2 injections were necessary. No significant side effects were seen. However, some mild pain persisted in some patients who participated in sports. Conclusion: The injection of 2.5 mL of 70% ethanol under fluoroscopic and electroneurographic guidance was a safe method for the treatment of MRI-verified Morton's neuromas. Combining the effect of a higher percentage of alcohol and a higher dosage and an improved localization technique resulted in a high rate of patients without pain. Level of Evidence: Level IV, cases series, prospective. [ABSTRACT FROM AUTHOR]

Although many treatment modalities are available for Morton's neuroma, the injection of the neuroma with alcohol has gained popularity. However, recently, some investigators have observed a progressive deterioration in pain scores for patients initially pain free after the treatment. The purpose of the present retrospective comparative study was to determine whether mechanical metatarsalgia is related to symptom recurrence. We included 104 consecutive cases of ultrasound-guided alcohol injection for Morton's neuroma in 92 patients. Of these 104 cases, 51 were in group A (49%; Morton's neuroma) and 53 in group B (51%; Morton's neuroma associated with mechanical metatarsalgia). We evaluated each patient using a visual analog scale and American Orthopaedic Foot and Ankle Society forefoot scale, and Johnson satisfaction scale, with a mean follow-up period of 24 (range 12 to 39) months. Concomitant functional and mechanical disorders have been identified and treated with orthopedic inserts. The present study compared the clinical results and recurrence of symptoms in patients with isolated Morton's disease or Morton's disease associated with mechanical metatarsalgia. Of the 104 cases, the patients for 93 cases (89%) were completely satisfied or satisfied with minor reservations. No major complications developed. Symptoms recurred in 6 patients (6%), in whom neuroma was associated with mechanical disorders ( p = .0269). Ultrasound-guided alcohol injection of Morton's neuroma is a relatively safe and well-tolerated treatment. Symptom recurrence is often associated with mechanical metatarsalgia. The treatment of the concomitant anatomical and functional disorders that target the genesis of the neuroma has an important role in the prevention of recurrence of this pathology. [ABSTRACT FROM AUTHOR]

Morton's neuroma, also known as interdigital neuroma, is a common cause of forefoot pain. It is a compressive neuropathy of the interdigital nerve, which is compressed by the overlying transverse metatarsal ligament. It is not a true tumor. The symptoms are forefoot pain that radiates into the toes, according to the involved nerve branches. Its histological findings are fibrosis around the nerve, demyelination. The clinical diagnosis can be obtained from a detailed history and physical examination, such as the compressive test. Moreover, ultrasonography and magnetic resonance imaging can also be used. Conservative treatment is the common initial treatment modality for interdigital neuroma. Surgical excision or decompression is indicated after a failure of conservative treatments. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present study was to evaluate patients following Morton's neuroma excision using a dorsal approach. Methods: From January 2007 to December 2013, 23 feet of 21 patients underwent surgical excision of interdigital neuroma using a dorsal approach. Patients were evaluated at a mean of 43.4 months (range, 18-93 months) and asked for pain, activity limitations, footwear modifications, walking distance, numbness, and overall satisfaction with results of the surgery. American Orthopedic Foot Ankle Society (AOFAS) Lesser Metatarsophalangeal- Interphalangeal Scale and Gianni interdigital neuroma clinical evaluation score were assessed. Results: None of the patients had surgical complications, and none of them required revision surgeries. The average AOFAS score was 93.7 (SD, 7.63; range, 78-100), and the neuroma score was 68.2 (SD, 7.78; range, 50-80). Excellent results were reported for 18 feet (78%), good results for 3 feet (13%), and fair results for 2 feet (9%). Minor pain, not impairing patients' daily life, was reported for 8 feet (35%), and 5 patients preferred using comfortable shoes following the surgery. Numbness was assessed in 14 feet (60%). All of the patients were completely satisfied with the surgery and expressed that they can recommend the procedure to others. Conclusion: Surgical excision of Morton's neuroma results in excellent and good outcome in majority of the patients for mid-long term follow-up. Minor pain and numbness do not affect patients' overall satisfaction and do not impair their daily life. Interdigital neuroma excision using a dorsal approach is a satisfactory treatment method for patients and surgeons. (JAREM 2016; 6: 45-8) [ABSTRACT FROM AUTHOR]

Patients with Morton's neuroma are rarely referred to physical therapy. This case reports the resolution of pain, increase in local pressure pain thresholds, and improvement of scores on the Lower Extremity Functional Scale and Foot and Ankle Ability Measure following a course of joint based manual therapy for a patient who had failed standard conservative medical treatment. [ABSTRACT FROM AUTHOR]

Background: Diagnosis of an interdigital neuroma (IDN) is clinically based on patient symptoms. During operative excision, it is common to send the excised specimen for routine histopathologic examination. The purpose of this study was to evaluate the accuracy of the clinical and intraoperative diagnosis of IDN and correlate these with the histopathologic results of IDN. Methods: Case logs of 3 fellowship-trained foot and ankle surgeons were reviewed to identify all neuroma excisions completed between 1997 and 2014. Charts were reviewed to identify the preoperative clinical diagnosis and intraoperative diagnosis as well as concern for pathology besides a neuroma. All results were compared to final histopathology to identify instances of discordance between diagnoses. A total of 123 patients with 133 neuromas were identified. Results: Of the total 133 neuromas, 5 cases included a clinical or intraoperative concern for a diagnosis other than neuroma. In these 5 instances surgeons accurately identified cysts and rheumatoid nodules. 132 of 133 histopathology reports indicated the presence of nerve tissue in their report. There were no reports of malignancy or abnormal nerve tissue. There were no changes to the postoperative protocol based on histopathology. Conclusion: The clinical, intraoperative, and histopathologic diagnosis of neuroma was in concordance 100% of the time. With a high level of clinical and intraoperative acumen in identifying a neuroma, we believe it is reasonable not to submit the specimen for histopathologic evaluation. In addition, limiting the amount of routine histopathologic evaluation could have saved approximately $480 per case. Level of Evidence: Level IV, case series. [ABSTRACT FROM AUTHOR]

Background: Simple neurectomy is a standard treatment of interdigital nerve neuroma after failure of conservative treatment. Recently, neurectomy with intramuscular implantation of the proximal nerve stump has been proposed as a safe and effective alternative method providing significant pain improvement. However, there remains little evidence supporting one technique over the other. The purpose of this study was to compare functional outcomes and complications of simple neurectomy versus neurectomy with intramuscular implantation. Methods: Retrospective chart review along with prospectively collected data of 99 consecutive patients (105 feet with 118 neuromas) who were diagnosed with interdigital neuroma of the foot and underwent simple neurectomy (66 patients / 72 feet / 78 neuromas) and neurectomy with intramuscular implantation of proximal nerve stump into intrinsic muscle of foot (33 patients / 33 feet / 40 neuromas) between 2000 and 2013. The minimum follow-up to be included in the study was 6 months for both techniques (mean = 44.6 months, range = 6 to 150 months for simple neurectomy; and mean = 19.3 months, range = 6 to 66 months for neurectomy with intramuscular implantation of proximal nerve stump into the intrinsic muscle). The primary outcomes were Foot Function Index (FFI); pain, disability, activity limitation, and total score, Short Form-36 (SF-36: physical and mental component scores); and visual analog scale (VAS). Secondary outcomes included operative time and complications. Pre- and postoperative SF-36, and FFI, and pain (VAS) scores were obtained and compared using a paired t test. An independent t test was used to assess the functional outcomes and operative time between the 2 groups, and a chi-square test was used to compare the complications between the 2 techniques. Results: Both groups demonstrated significant improvement of postoperative functional outcomes (FFI, SF-36, and VAS; P < .001, all) compared to the preoperative period. Neurectomy with intramuscular implantation demonstrated significant improvement of pain compared to simple neurectomy as measured with VAS (P = .002); however, the operative time was significantly longer than the simple neurectomy technique (P = .001). The rest of the functional outcomes measured were comparable between the 2 techniques. Complications in both simple neurectomy and implantation techniques were persistent pain (11.5% vs 2.5%, P = .07), revision rate (5.1% vs 0.0%, P = .08), and painful scar (5.1% vs 5.0%, P = .83), respectively, but it did not reach statistical significance (P > .05, all). Conclusion: Both simple neurectomy and neurectomy with intramuscular implantation demonstrated significant improvement in terms of functional outcomes as measured with the FFI, SF-36, and VAS in patients with interdigital neuroma. Although requiring a longer operative time, neurectomy with intramuscular implantation technique might offer superior pain relief with comparable complications to the simple neurectomy technique. Level of Evidence: Level III, retrospective comparative study. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess the diagnostic accuracy of 7 clinical tests for Morton's neuroma (MN) compared with ultrasonography (US). Forty patients (54 feet) were diagnosed with MN using predetermined clinical criteria. These patients were subsequently referred for US, which was performed by a single, experienced musculoskeletal radiologist. The clinical test results were compared against the US findings. MN was confirmed on US at the site of clinical diagnosis in 53 feet (98%). The operational characteristics of the clinical tests performed were as follows: thumb index finger squeeze (96% sensitivity, 96% accuracy), Mulder's click (61% sensitivity, 62% accuracy), foot squeeze (41% sensitivity, 41% accuracy), plantar percussion (37% sensitivity, 36% accuracy), dorsal percussion (33% sensitivity, 26% accuracy), and light touch and pin prick (26% sensitivity, 25% accuracy). No correlation was found between the size of MN on US and the positive clinical tests, except for Mulder's click. The size of MN was significantly larger in patients with a positive Mulder's click (10.9 versus 8.5 mm, p = .016). The clinical assessment was comparable to US in diagnosing MN. The thumb index finger squeeze test was the most sensitive screening test for the clinical diagnosis of MN. [ABSTRACT FROM AUTHOR]

The article discusses a retrospective study that examined the effectiveness of ultrasonography-guided alcohol injection to treat Morton's neuroma in 508 patients at two medical centers. Topics discussed include assessment of patients with a visual analogue scale for pain before signing informed consent, histological examination of all neuromas, and percentage of more than 500 patients who expressed satisfaction with the treatment received.

Background: Previous studies have shown that the injection of dehydrated alcohol has been successful for the treatment of Morton's neuroma in the foot. In this study, we determined the cellular effect of injection of alcohol into and around the sciatic nerve of rats and measured the extent of cell necrosis and/or any associated histologic or inflammatory changes. Methods: Twenty-two male (∼375 g) Wistar rats were randomized into 2 groups each receiving alcohol injections into or around the sciatic nerve after nerve exposure under sterile technique. Group 1 rats were injected with a 0.5 ml solution of 0.5% Marcaine in the left sciatic nerve as a control group. In the right sciatic nerve a 0.5 ml solution of 4% ethanol with 0.5% Marcaine was injected. Group 2 rats received 0.5 ml of 20% ethanol with 0.5% Marcaine injected into the left sciatic nerve and 0.5 ml of 30% ethanol with 0.5% Marcaine injected into the right sciatic nerve. In each group, the rats were placed in 3 subgroups: intraneural, perineural, perimuscular injections. All rats were sacrificed and tissue harvested for histologic evaluation at day 10 post injection. Results: No evidence of alcohol-associated cell necrosis, apoptosis, or apparent inflammation was observed in histologic specimens of any injected nerves, perineural tissue, or muscles in controls or experimental groups regardless of concentration of ethanol injected on day 10. Conclusion: We concluded that alcohol injection (≤30% ethanol) into and/or around the sciatic nerve or the adjacent muscle of rats has no histologic evidence of necrosis or inflammation to the nerve or surrounding tissue. There was no observable histological change in apoptosis, or cell number, in response to the alcohol injection. Clinical Relevance: The lack of any measureable changes in nerve or adjacent muscle histology with ethanol injection into the rat sciatic nerve (and surrounding tissues) raises questions about the efficacy of using ethanol injections in the treatment of Morton's neuroma in human clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To identify the variety of second and third intermetatarsal space (IS) lesions that may coexist with and without adjacent metatarsophalangeal joint (MTP) plantar plate (PP) tears. Materials and methods: One hundred forefoot MRIs in 96 patients with metatarsalgia obtained between 30 September 2011 and 21 July 2012 using 1.5- or 3-T MRI were retrospectively reviewed in consensus by two MSK radiologists and one podiatrist (DPM). MRI was evaluated for second and third MTP PP tear and the presence/nature of second and third IS lesions. Second and third IS neuromas were measured in transverse (trans) dimension. Results: A total of 40 PP tears were identified: 36 at the second and 4 at the third MTP. Second MTP PP tear was identified in 33 % of females and 40.5 % of males. In the 63 female feet there were 21 second MTP PP tears, all of which also had second IS lesions: pericapsular fibrosis (16), bursitis (4), and ganglion (1). In the 37 male feet there were 15 second MTP PP tears, 14 of which had second IS lesions: pericapsular fibrosis (8), bursitis (5), and ganglion (1). There was no definite second IS neuroma adjacent to any second MTP PP tear. In females without PP tear, there were 24 second (3 mm trans average) and 43 third IS neuromas (4.1 mm trans average). In males without PP tear, there were 9 second (3.4 mm trans average) and 16 third IS neuromas (4.1 mm trans average). Conclusions: MTP PP tears occurred in 40 % of our cases, 90 % of which occurred at the second MTP. Almost all coexisted with non-neuromatous second IS lesions. [ABSTRACT FROM AUTHOR]

Background: Although many treatment modalities are available for Morton's neuroma (MN), studies looking at the long- term effectiveness of most forms of treatment are scarce. The injection of MN with alcohol has gained popularity over the past 10 years with widespread media coverage. Many surgeons have anecdotally questioned the long-term effectiveness of this treatment. We reviewed a cohort of patients at an average 5-year follow-up to assess the medium-term results of alcohol injection. Methods: We used the modified Johnson score and visual analogue scales to assess 45 of the original cohort of patients with an average follow-up of 61 months (range, 33-73 months). Any complications from the procedure were also noted. Results: Our results indicated that by 5 years, 16 of 45 patients had undergone surgical treatment and a further 13 patients had return of symptoms. Only 29% (13/45) remained symptom free. The visual analog scale and modified Johnson scores showed statistically significant deterioration in patients' symptoms at 5 years following alcohol injection. Conclusion: Injection with alcohol sclerosant for MN has been marketed as a definitive management option comparable to surgical excision. Our investigation illustrated that although short-term results are encouraging, alcohol injection does not offer permanent resolution of symptoms for most patients and can be associated with considerable morbidity. Our investigation provides the only long-term data for alcohol injection treatment of MN. Level of Evidence: Level II, prospective case series. [ABSTRACT FROM AUTHOR]

The article discusses the correlation of third webspace injections in patients with interdigital neuroma (IDN), a benign neuroma of an intermetatarsal plantar nerve. It examines the anatomical localization and the level of extravasation with injection for IDN using computed tomography (CT) scans. It notes that the injection for IDN was accurate for treatment consequences, and not for diagnostic functions.

The article reports on research which was conducted to determine whether alcohol sclerosing therapy which is administered without alcohol is a safe and effective treatment for interdigital neuroma. Researchers evaluated 32 patients. They found that alcohol sclerosing therapy administered in a clinic setting without alcohol is not an effective treatment in the management of interdigital neuromas.

Steroid injection is frequently used in the treatment of interdigital neuroma and has a high rate of success. We report the case of a patient who develops skin depigmentation at the injection site and linear streaks of depigmentation over the foot, the ankle and half way up to the knee after a steroid injection for interdigital neuroma. Minor disadvantages such as subcutaneous fat atrophy and depigmentation of the skin at the injection site are well known problems following steroid injection. Depigmentation of the skin with a lymphatic distribution in the foot after steroid injection for interdigital neuroma however, has not yet been reported before. This complication is a serious aesthetic problem and clinicians should be aware of this complication when treating patients with steroid injections for interdigital neuroma. [ABSTRACT FROM AUTHOR]

The Authors present their experience in the surgical treatment of Morton’s neuroma via a dorsal approach. The assessed results have been very good in terms of a clear clinical improvement and no recurrences in all the treated cases. The histological examination carried out on all the removed samples have shown that the thickening of the nerve first occurs due to perineural fibrosis and successively associated with sclerohyalinosis of the tissue, which is in line with the already existing literature reports. The Authors of the article reckon the adopted surgical technique to be simple, safe and highly effective. [ABSTRACT FROM AUTHOR]

Abstract: A total of 117 patients with suspected interdigital neuroma (IDN) were investigated with ultrasound scan and 90 (68%) IDN cases were demonstrated. From this group, histological analysis confirmed that 88 cases (98%) were IDN. Three cases with persistent symptoms despite a negative ultrasound scan were surgically explored and two cases had histological confirmation of an IDN. The sensitivity of ultrasound scan in the diagnosis of IDN was 98% and its specificity was 95%. The most common anatomical site was the third interspace (80%). There were a higher proportion of females diagnosed with this condition. Ultrasound appears to be an accurate and effective technique in diagnosing and localizing an IDN when applied as an adjunct to clinical symptoms and signs in cases of metatarsalgia. [Copyright &y& Elsevier]