Hazem Z. Hassounaa, , and Dishan Singhb, 1,
aPrincess Royal Hospital, Orthopaedics Department, Haywards Heath RH16 4EX, UK bRoyal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4TB, UK
Morton’s Metatarsalgia is a painful condition and can often be debilitating. The value of surgical exicion has been doubted due to low success rate of surgical intervention.
The purpose of this study is to examine the variation in the management steps of Morton’s Metatarsalgia.
Several surgeons from different European countries answered a questionnaire in regard to their routine management of a typical Morton’s neuroma patient.
Twenty-five surgeons (100%) stated they would routinely elicit intermetatarsal tenderness in comparison to 14 (56%) and 10 (40%) surgeons who would routinely elicit intermetatrsal tenderness and Mulder’s click, respectively. The majority of them (84%) will routinely request plain foot radiograph, while seven surgeons (28%) use ultrasound routinely. Coservative management is initiated by 16 surgeons (64%). Local injection was first line of treatment among 13 surgeons (56%). Surgical treatment is favoured by 10 surgeons (40%), while only 1 surgeon (4%) would use ultrasound-guided injection routinely. The popular surgical approach is dorsal incision (75%). If a surgical option was chosen then neurectomy is attempted by 17 (68%) surgeons.
Considerable variation exists among continental surgeons in their initial management of a typical Morton’s neuroma patient. This is probably due to lack of understanding of the true aetiology of the Morton’s neuroma.
The Foot Volume 15, Issue 3 , September 2005, Pages 149-153.