Plantar approach for Morton's neuroma: An effective technique for primary excision.

BACKGROUND: Morton's neuroma is a common cause of inter-metatarsal foot pain. Surgical excision is generally indicated when non-operative measures have been unsuccessful; various surgical techniques have been described in the literature for excision, with no consensus on the overall ideal surgical approach.

AIM: To assess patient outcomes and complications following plantar surgical approach to neurectomy in a consecutive series of patients.

METHOD: An analysis of consecutive patients undergoing excision of Morton's neuroma using a plantar approach by a single surgeon over a 12 month period. Pre- and post-operative AOFAS and VAS scores were completed during outpatient visits.

RESULTS: 20 patients were included in the study, with pre-operative confirmation of a soft tissue mass on ultrasound scan. All patients demonstrated improvement in their post-operative functional scores; 2 patients (10%) did not have full resolution of their symptoms post-operatively. Mean AOFAS scores improved from 39 to 80 post-operatively and VAS from 40 to 92. No patients had wound complications or scar pain.

CONCLUSION: Neurectomy performed via a plantar approach provides good exposure, adequate soft tissue healing, with rapid resolution of pain and return to normal activities post-operatively.