Ettehadi Hossein, Saragas Nikiforos Pandelis, Ferrao Paulo
The Orthopaedic Foot and Ankle Unit, Netcare Linksfield Hospital, Johannesburg, South Africa; Department of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa.
The Orthopaedic Foot and Ankle Unit, Netcare Linksfield Hospital, Johannesburg, South Africa; Department of Orthopaedic Surgery, University of the Witwatersrand, Johannesburg, South Africa.
Foot Ankle Surg. 2022 Dec;28(8):1210-1214. doi: 10.1016/j.fas.2022.03.013. Epub 2022 Mar 31.
Interdigital neuroma is one of the commonest causes of metatarsalgia. The reported success rate after excision of a primary neuroma is 74%. Recurrent symptoms after neurectomy can be due to a recurrent interdigital neuroma. Recurrent interdigital neuromas can be diagnosed using sound clinical examination and ultrasonography. Surgical excision is the best treatment modality with varying success reported in the literature. We report on the clinical outcome following surgical excision of recurrent interdigital neuromas through a dorsal approach. All patients who had undergone excision of a recurrent interdigital neuroma by a single surgeon between 01/2010 and 12/2019 were identified. Inclusion criteria included patients having a preoperative ultrasound and postoperative histology report. The exclusion criteria were preexisting neuropathy or tarsal tunnel syndrome. Demographic data was collected, and a self-reported foot and ankle score questionnaire (SEFAS) was completed by the patient at their most recent follow-up. Twenty-three patients (25 feet) were included in the study. Mean time of follow-up was 75 (range 14-189) months. The mean age was 49 (range 15-71) years. Eleven (44%) recurrent neuromas were excised from the second webspace and 14 (56%) were excised from the third webspace. All excised masses were confirmed as recurrent neuromas histologically. Regarding the SEFAS score, 17 (73.93%) patients scored as excellent, one (4.34%) as good, three (13.04%) as fair, and two (8.69%) as poor. This long term follow-up study on outcomes after surgery for recurrent interdigital neuroma suggests that excision through a dorsal approach is an effective treatment option with a high patient satisfaction.
趾间神经瘤是跖痛症最常见的病因之一。据报道，原发性神经瘤切除术后的成功率为74%。神经切除术后复发症状可能是由于复发性趾间神经瘤。复发性趾间神经瘤可通过完善的临床检查和超声检查来诊断。手术切除是最佳治疗方式，文献报道的成功率各不相同。我们报告了通过背侧入路手术切除复发性趾间神经瘤后的临床结果。确定了2010年1月至2019年12月期间由单一外科医生切除复发性趾间神经瘤的所有患者。纳入标准包括有术前超声和术后组织学报告的患者。排除标准为既往存在神经病变或跗管综合征。收集了人口统计学数据，患者在最近一次随访时完成了一份自我报告的足踝评分问卷（SEFAS）。23例患者（25只足）纳入研究。平均随访时间为75（14 - 189）个月。平均年龄为49（15 - 71）岁。11例（4４%）复发性神经瘤从第二趾蹼间隙切除，14例（56%）从第三趾蹼间隙切除。所有切除的肿物经组织学证实为复发性神经瘤。关于SEFAS评分，17例（73.93%）患者评为优秀，1例（4.34%）为良好，3例（13.04%）为中等，2例（8.69%）为差。这项关于复发性趾间神经瘤手术后结果的长期随访研究表明，通过背侧入路切除是一种有效的治疗选择，患者满意度高。
