Lee Kyung Tai, Kim Jun Beom, Young Ki Won, Park Young Uk, Kim Jin Su, Jegal Hyuk
Foot and Ankle Clinic, KT Lee's Orthopedic Hospital, Seoul, Republic of Korea.
Foot Ankle Spec. 2011 Dec;4(6):349-53. doi: 10.1177/1938640011428510. Epub 2011 Dec 1.
The objective of this retrospective study was to evaluate the long-term follow-up results of neurectomy clinical outcomes and complications in the treatment of Morton's neuroma.
A total of 19 patients (19 different feet) were treated for Morton's neuroma by excision of the interdigital nerve at our institute between May 1997 and May 1999. Thirteen (13 feet) of them were followed up. The 13 patients were female and had an average age of 43 years (range 34-54 years) at the time of the operation. The patients were followed-up for a mean of 10.5 years (range 10.0-12.2 years) and scored using the American Orthopaedic Foot & Ankle Society (AOFAS) forefoot scoring system and Visual Analogue Scale (VAS) score. Subjective satisfaction was evaluated at the final follow-up.
Eight patients scored more than 90 on the AOFAS forefoot scoring system. The VAS score was improved in all patients. The mean preoperative VAS score was 8.6 ± 0.8 cm (7-10) and the mean follow-up VAS score was 2.4 ± 1.8cm (0-6), which indicated no significant difference (P > .05). The final follow-up satisfaction results indicated that 4 patients were completely satisfied with the operation, 4 were satisfied with minor reservations, 5 were satisfied with major reservations, and no patient was unsatisfied. Neurectomy to treat Morton's neuroma had a good satisfaction rate (61%). Eleven of the patients complained of numbness on the plantar aspect of the foot adjacent to the interspace, and 2 of these 11 patients complained of disability induced by severe numbness. There was a complaint of residual pain by 1 patient. There were no skin problems on the operation lesions.
The long-term results of neurectomy clinical outcomes in Morton's neuroma are slightly worse than the short- and mid-term results.
Therapeutic, Level IV, Retrospective case series.
本回顾性研究的目的是评估神经切除术治疗 Morton 神经瘤的临床疗效和并发症的长期随访结果。
1997 年 5 月至 1999 年 5 月期间，我院共 19 例（19 只不同的脚）患者因 Morton 神经瘤接受了趾间神经切除术治疗。其中 13 例（13 只脚）进行了随访。这 13 例患者均为女性，手术时平均年龄为 43 岁（范围 34 - 54 岁）。患者平均随访 10.5 年（范围 10.0 - 12.2 年），并采用美国矫形足踝协会（AOFAS）前足评分系统和视觉模拟量表（VAS）评分。在最后一次随访时评估主观满意度。
8 例患者 AOFAS 前足评分系统得分超过 90 分。所有患者的 VAS 评分均有所改善。术前 VAS 评分平均为 8.6 ± 0.8 cm（7 - 10），随访时 VAS 评分平均为 2.4 ± 1.8 cm（0 - 6），差异无统计学意义（P > 0.05）。最后一次随访的满意度结果显示，4 例患者对手术完全满意，4 例有轻微保留意见表示满意，5 例有较大保留意见表示满意，无患者不满意。神经切除术治疗 Morton 神经瘤的满意度较高（61%）。11 例患者抱怨手术间隙相邻足底区域麻木，其中 2 例患者抱怨严重麻木导致功能障碍。有 1 例患者抱怨残留疼痛。手术切口处无皮肤问题。
神经切除术治疗 Morton 神经瘤的长期临床疗效略逊于短期和中期疗效。
治疗性，IV 级，回顾性病例系列。
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