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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Surgical treatment of Morton’s neuroma – results from the last ten years

Die operative Behandlung der Morton-Metatarsalgie: Ergebnisse aus den letzten zehn Jahren

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Frank Staub - Praxis für periphere Neurochirurgie, Dossenheim, Deutschland
  • Thomas Dombert - Praxis für periphere Neurochirurgie, Dossenheim, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV153

doi: 10.3205/22dgnc151, urn:nbn:de:0183-22dgnc1519

Veröffentlicht: 25. Mai 2022

© 2022 Staub et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Objective: Morton’s neuroma is a common pathology affecting the forefood. Morphologically it is not a true neuroma but thickening and fibrosis of a digital nerve (pseudo–neuroma). Patients complain of typical severe pain on weight bearing, which is exacerbated by use of tight foodware. The physical examination includes palpation of the web spaces and Mulder’s test. Surgical treatment has been reported to be effective. In this context, patients with operative treatment from the last ten years were analyzed.

Methods: 173 patients operated from 01/2010 to 06/2021 were included to the study. In all patients MRI was used to confirm an intermetatarsal neuroma. Excision of the neuroma was performed by the dorsal approach using local anesthesia and a bloodless field with a tournique at the ankle. Patients' age, gender ratio, localization of the neuroma and complications were analyzed. Concerning clinical outcome a questionnaire was returned by 117 patients. Furthermore, results of the recent study were compared to those of patients evaluated from 1986 to 1992 (Assmus 1994, Nervenarzt 65: 238-40). At that time no MRI war performed before surgery.

Results: The average age of the patients was 55.6±9.4 year, 77.5% of them were female and 22.5% male. In 68.2% the neuroma was localized in the third intermetatarsal space, in 31.2% in the second and as rarity in 0.6% (one patient) in the first intermetatarsal space. Disorder or delay of wound healing was found in 8.7% of the patients, mainly caused by suture dehiscence and necrosis of skin margins. After neurectomy 61.2% of the patients were free of complaints, another 25.6% reported minor pain. Only slight or no improvement was found in 7.4% or 5.8% of the patients, respectively. The results were largely independent of wound healing delay or disturbance. Compared to patients investigated in 1986-1992 excellent and good results were about the same, but the amount of patients without benefit from surgery at that time was twice as high (11.1% vs. 5.8%).

Conclusion: Mostly good to excellent results (>85%) were achieved after excision of Morton’s neuroma, localized in two-thirds of the patients in the third, one-third in the second and rarely in the first intermetatarsal space. A considerable amount of wound healing disturbance did not compromise the results. Comparing studies with and without MRI before surgery underlines the importance of clinical examination for diagnosis. On the other hand imaging may help to exclude patients who will not benefit from surgery.