Morton’s neuroma is a thickening of the nerve passing between the third and fourth metatarsal bones. It is a benign tumour caused by repeated impacts against the ground or by a small space between the bones of the foot compressing the nerve. Traditional surgery solves the problem by removing the neuroma, which usually improves symptoms but causes an unpleasant loss of sensation and in some cases worsens the disease, forming a nerve callus or painful scar that is difficult to treat. The satisfaction rate is around 50-60%. This surgery usually involves a long postoperative period which affects the patient’s ability to return to work and sport.
At CLINICA MAYRAL foot center we treat Morton’s neuroma with ultrasound-guided surgery.
Morton’s neuroma, as described above, is an inflammation/degeneration of the plantar digital nerve whose physiological transverse diameter is 1-2 mm. It is very common to find it thickened on ultrasound.
This nerve occupies the third intermetatarsal space, below the intermetatarsal ligament.
Sometimes, the nerve in question is irritated, even if it is no more than 6 mm thick, causing excruciating pain typical of a real neuroma. The causes of this pain can be intrinsic or extrinsic, but the condition is often associated with intermetatarsal bursitis.
The presence of this bursitis causes a narrowing of the nerve space as it passes through this canalicular region, increasing the “entrapment” effect of the nerve.
In other words, it is a nerve entrapment syndrome (sensory) between the third and fourth metatarsal with an often inflamed bursa and a tense ligament that joins them.
At CLINICA MAYRAL we carry out an ultrasound examination to make a correct podiatric diagnosis that allows us to guide the patient towards the most correct therapeutic indication
There are patients who have a family history and present this deformity from a very early age.
It is then that we begin to assess the intervention from the age of 16, although in advanced cases it is even possible to operate earlier, taking into account the growth plates.
In young patients, the most fundamental principles of biomechanics and functionality must be taken into account in order to achieve a good result for the rest of the patient’s life.
Ultrasound-guided radiofrequency and minimally invasive surgery.
At CLÍNICA MAYRAL the therapeutic indication of removing the nerve by means of MINIOPEN surgery with a less traumatic dorsal approach is given only for the most serious cases.