Diebold P F, Delagoutte J P
Acta Orthop Belg. 1989;55(3):467-71.
The authors consider Morton's neuroma as a tunnel syndrome, the most likely etiology being the compression of the nerve by the intermetatarsal ligament. Therefore, they have treated Morton's disease by decompression of the intermetatarsal nerve via a dorsal approach. They operated 45 patients, 82% of whom were women. In 85% of the cases, a large neuroma was found and they did not find the theoretical predominance of the 3rd intermetatarsal space; 9 times in 10, the treatment consisted in epineural dissection of the nerve and its collaterals at the bifurcation. In 84% out of the cases, the result was satisfactory; associated pathology was treated at the same time. The authors discuss the results and emphasize that, in case of failure, a simple neurectomy may be used.
作者认为莫顿神经瘤是一种管综合征,最可能的病因是跖间韧带对神经的压迫。因此,他们通过背侧入路对跖间神经进行减压来治疗莫顿病。他们对45例患者进行了手术,其中82%为女性。在85%的病例中发现了大的神经瘤,且未发现理论上第三跖间隙的优势;十分之九的情况下,治疗方法是在神经分叉处对神经及其分支进行神经外膜剥离。84%的病例结果令人满意;同时对相关病理情况进行了治疗。作者讨论了结果并强调,若治疗失败,可采用单纯神经切除术。