Austral University Hospital, Pilar, Buenos Aires, Argentina.
Foot Ankle Int. 2020 Oct;41(10):1226-1233. doi: 10.1177/1071100720936599. Epub 2020 Jul 16.
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.
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.
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 ( < .01). Excellent and good satisfaction outcomes were achieved in 93.6%. The postoperative complication incidence was 3%.
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 IV, retrospective case series.
Morton 神经瘤是跖痛症的常见病因。如果非手术治疗失败，则需要手术治疗。本研究的目的是描述一种通过微创关节切开术切除 Morton 神经瘤的技术，并评估其长期结果和并发症。
对 1990 年 9 月至 2010 年 12 月间通过关节切开术治疗的 108 例 Morton 神经瘤患者进行回顾性研究。描述了手术技术。评估了临床结果和并发症。平均随访时间为 121 个月。11 名患者为男性，97 名患者为女性。平均年龄为 49.4 岁；56.8%的神经瘤位于第三间隙，43.2%位于第二间隙。6 例患者同一足有 2 个神经瘤，9 例患者有双侧神经瘤。
术前视觉模拟评分（VAS）平均疼痛评分为 5.4 分，末次随访时为 0.2 分。作者发现术前和术后 VAS 评分有显著差异（<0.01）。93.6%的患者获得了优秀和良好的满意度。术后并发症发生率为 3%。
作者认为微创关节切开术优于背侧或足底切口。它是一种简单且可重复的技术，具有满意的结果、低并发症发生率和快速恢复正常活动。
四级，回顾性病例系列。
