DeHeer Patrick A, Nanrhe Artinder P, Michael Shannon R, Standish Sarah N, Bhinder Christine D, Foster Todd L
J Am Podiatr Med Assoc. 2020 Jul 22. doi: 10.7547/18-089.
Morton's neuromas are abnormalities of the common digital nerve branch located between the lesser metatarsal heads. Historically, interdigital (Morton's) neuromas have been characterized as being most common in the third interspace and predominantly identified in females. The principal investigator observed Morton's neuromas commonly in both the 2nd and 3rd interspaces in both genders. To the best of our knowledge, no literature exists to evaluate Morton's neuroma location with a focus on each gender independently. The present study evaluates Morton's neuroma interspace location and if there is a variation between males and females.
In this retrospective study, 582 de-identified ProScan magnetic resonance imaging reports, with a diagnosis code for Morton's neuroma (ICD Code 355.6), were obtained from their centralized database. These reports were evaluated for patients scanned from January 2015-April 2016. Incomplete records and those where the radiologist findings were not consistent with Morton's neuroma were eliminated. For the remaining 379 patients, data was collected on several factors such as gender, laterality, history of trauma, plantar plate tear, age and interspace location. Special focus was given to second and third interspace Morton's neuromas. Data was then evaluated statistically utilizing the Pearson Chi-Square and Independent Samples Mann-Whitney U Test with statistical significance deemed p<0.05.
No statistically significant distribution between gender and second and third interspace Morton's neuromas were noted. Additionally, right vs left foot, age and history of trauma did not vary between genders in a significant way. Lastly, there was a statistically significant difference between the presence of plantar plate tears between genders. Male patients with Morton's neuromas were found to have a higher rate of plantar plate tears (34/92, p=0.01).
Our study found that there was not a statistically significant difference between female and male and Morton's neuromas location, laterality or age.
莫顿神经瘤是位于小趾跖骨头之间的常见趾神经分支的异常情况。从历史上看，趾间（莫顿氏）神经瘤的特征是在第三间隙最为常见，且主要见于女性。主要研究者观察到莫顿神经瘤在男女的第二和第三间隙都很常见。据我们所知，尚无文献专门针对男女分别评估莫顿神经瘤的位置。本研究评估莫顿神经瘤的间隙位置以及男女之间是否存在差异。
在这项回顾性研究中，从集中数据库获取了582份去识别化的ProScan磁共振成像报告，这些报告有莫顿神经瘤的诊断代码（ICD代码355.6）。对2015年1月至2016年4月期间扫描的患者的这些报告进行评估。排除记录不完整以及放射科医生的检查结果与莫顿神经瘤不符的情况。对于其余379名患者，收集了性别、侧别、创伤史、跖板撕裂、年龄和间隙位置等多个因素的数据。特别关注第二和第三间隙的莫顿神经瘤。然后使用Pearson卡方检验和独立样本曼-惠特尼U检验对数据进行统计学评估，统计学显著性设定为p<0.05。
未发现性别与第二和第三间隙莫顿神经瘤之间存在统计学上的显著分布差异。此外，右脚与左脚、年龄和创伤史在性别之间也没有显著差异。最后，男女之间跖板撕裂的存在情况存在统计学上的显著差异。发现患有莫顿神经瘤的男性患者跖板撕裂的发生率更高（34/92，p = 0.01）。
我们的研究发现，男女之间莫顿神经瘤的位置、侧别或年龄没有统计学上的显著差异。
