Isolated Intermetatarsal Ligament Release as Primary Operative Management for Morton's Neuroma: Short-term Results.

Autor:	Elghazy MA; Foot and Ankle Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (MAE, GRW, KCW).; the Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Egypt (MAE).; Georgetown University School of Medicine, Washington (KCW).; Harvard Medical School, Foot and Ankle Service, Department of Orthopaedic Surgery, Massachusetts General Hospital and Newton-Wellesley Hospital, Boston, Massachusetts (DG, CWD).; Foot and Ankle Service, Hospital of Special Surgery, New York, NY (AHJ)., Whitelaw KC; Foot and Ankle Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (MAE, GRW, KCW).; the Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Egypt (MAE).; Georgetown University School of Medicine, Washington (KCW).; Harvard Medical School, Foot and Ankle Service, Department of Orthopaedic Surgery, Massachusetts General Hospital and Newton-Wellesley Hospital, Boston, Massachusetts (DG, CWD).; Foot and Ankle Service, Hospital of Special Surgery, New York, NY (AHJ)., Waryasz GR; Foot and Ankle Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (MAE, GRW, KCW).; the Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Egypt (MAE).; Georgetown University School of Medicine, Washington (KCW).; Harvard Medical School, Foot and Ankle Service, Department of Orthopaedic Surgery, Massachusetts General Hospital and Newton-Wellesley Hospital, Boston, Massachusetts (DG, CWD).; Foot and Ankle Service, Hospital of Special Surgery, New York, NY (AHJ)., Guss D; Foot and Ankle Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (MAE, GRW, KCW).; the Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Egypt (MAE).; Georgetown University School of Medicine, Washington (KCW).; Harvard Medical School, Foot and Ankle Service, Department of Orthopaedic Surgery, Massachusetts General Hospital and Newton-Wellesley Hospital, Boston, Massachusetts (DG, CWD).; Foot and Ankle Service, Hospital of Special Surgery, New York, NY (AHJ)., Johnson AH; Foot and Ankle Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (MAE, GRW, KCW).; the Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Egypt (MAE).; Georgetown University School of Medicine, Washington (KCW).; Harvard Medical School, Foot and Ankle Service, Department of Orthopaedic Surgery, Massachusetts General Hospital and Newton-Wellesley Hospital, Boston, Massachusetts (DG, CWD).; Foot and Ankle Service, Hospital of Special Surgery, New York, NY (AHJ)., DiGiovanni CW; Foot and Ankle Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (MAE, GRW, KCW).; the Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Egypt (MAE).; Georgetown University School of Medicine, Washington (KCW).; Harvard Medical School, Foot and Ankle Service, Department of Orthopaedic Surgery, Massachusetts General Hospital and Newton-Wellesley Hospital, Boston, Massachusetts (DG, CWD).; Foot and Ankle Service, Hospital of Special Surgery, New York, NY (AHJ).
Jazyk:	angličtina
Zdroj:	Foot & ankle specialist [Foot Ankle Spec] 2022 Aug; Vol. 15 (4), pp. 338-345. Date of Electronic Publication: 2020 Sep 19.
DOI:	10.1177/1938640020957851
Abstrakt:	Background: Although the precise pathoetiology of Morton's neuroma remains unclear, chronic nerve entrapment from the overlying intermetatarsal ligament (IML) may play a role. Traditional operative management entails neuroma excision but risks unpredictable formation of stump neuroma. Materials and Methods: Medical records were examined for adult patients who failed at least 3 months of conservative treatment for symptomatic and recalcitrant Morton's neuroma and who then underwent isolated IML decompression without neuroma resection. Results: A total of 12 patients underwent isolated IML decompression for Morton's neuroma with an average follow-up of 13.5 months. Visual Analog Pain Scale averaged 6.4 ± 1.8 (4-9) preoperatively and decreased to an average of 2 ± 2.1 (0-7) at final follow-up (P = .002). All patients reported significant improvement. Conclusion: Isolated IML release of chronically symptomatic Morton's neuroma shows promising short-term results regarding pain relief, with no demonstrated risk of recurrent neuroma formation, permanent numbness, or postoperative symptom exacerbation. Level of Evidence: Level IV: Case series .
Databáze:	MEDLINE
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