Department of Orthopaedics & Trauma, Airedale General Hospital, Steeton, Keighley, W. Yorkshire, BD20 6TD, UK.
Chin Med J (Engl). 2010 Aug;123(16):2195-8.
The choice for the surgical approach of interdigital neuroma in the foot is controversial. Plantar approach can leave a painful scar on weight bearing area; hence, some prefer dorsal approach. The aim of the current study was to measure the outcome of interdigital (Morton's) neurectomy performed by a single surgeon using dorsal and plantar approaches.
A retrospective review of the patient records of one orthopaedic foot and ankle surgeon identified thirty-six patients (42 feet) who had been treated operatively for a primary, persistently painful interdigital neuroma. The mean follow-up was 18 months. Pain, weight bearing, wound problems and rehabilitation period were studied.
The duration to full weight bearing, return to work, driving and recreational activities were at least one week shorter in the dorsal group. The overall satisfaction for surgery was rated as excellent or good in 85% of the thirty six patients. Scar problems were more troublesome and common in the plantar group. There was residual numbness noticed in twenty feet, the pattern of numbness was quite variable and it was bothersome in only seven feet. There was one recurrence in the plantar group.
Resection of a symptomatic interdigital neuroma through a dorsal or a plantar approach can result in a good outcome. Dorsal approach, however, is associated with better rehabilitation and less scar problems.
足部趾间神经瘤的手术入路选择存在争议。足底入路会在承重区域留下疼痛的疤痕，因此，一些人更喜欢背侧入路。本研究的目的是测量由一位外科医生使用背侧和足底入路进行的趾间（Morton's）神经切除术的结果。
对一位骨科足踝外科医生的患者记录进行回顾性分析，确定了 36 名（42 只脚）接受原发性、持续性疼痛性趾间神经瘤手术治疗的患者。平均随访时间为 18 个月。研究了疼痛、负重、伤口问题和康复期。
背侧组完全负重、恢复工作、驾驶和娱乐活动的时间至少缩短了一周。36 名患者中有 85%对手术的总体满意度评为优秀或良好。足底组的疤痕问题更麻烦和常见。20 只脚出现残留麻木，麻木模式变化很大，只有 7 只脚感到不适。足底组有 1 例复发。
通过背侧或足底入路切除有症状的趾间神经瘤可以获得良好的结果。然而，背侧入路与更好的康复和更少的疤痕问题相关。
