Abstract
Aim: Morton's metatarsalgia was described 145 years ago and its treatment was implemented in the Czech Republic 42 years ago. This is a rare entrapment syndrome on the foot, which may lead to the inability to walk.
Nevertheless, we did not find any evaluation of the operated collection of patients in our literature. The aim of the work is to make acquainted the readers with Morton's metatarsalgia modern diagnosis and surgical treatment on the basis of the own set of patients.
Patients and methods: The retrospective study includes 9 patients (8 women and 1 man) with a mean age of 47.4 years who were operated on between 2011 and 2017. The postoperative follow-up lasted 3-9 years.
The diagnosis was determined by a clinical examination, tests, ultrasonography, MRI, and postoperative histology. The preoperative conservative therapy and pain lasted 1-10 (average of 3.3) year(s).
Morton's neuroma on the common plantar digital nerve was radically removed by the dorsal approach. Results: In seven patients, the neuroma was located in the area between the heads of the IIIrd and the IVth metatarsus.
One female patient underwent resection in the space between the heads of the IInd and the IIIrd metatarsus. In one case, the neuroma occurred in both locations (between the heads of the IInd and the IIIrd and the IIIrd and the IVth metatarsus).
The histological findings confirmed the clinical diagnosis of Morton's neuroma. All operated patients, dysesthesia occurred, but only 5 patients were aware of changes in sensitivity.
There was no recurrence in with 3-9 years. Preoperative pain according to the Numeric Rating Scale (NRS) was 5-7 (average 5.88).
Postoperatively after 6 months, the pain reduced to 0-3 (on average 1.11) according to the NRS. Patients got back to normal walking and sports.
Conclusion: The work demonstrates that Morton's metatarsalgia can be successfully cured by the radical removal of the neuroma by the dorsal approach.