SmartHallux® Method
Smarthallux explains to you
All you need to know
on Morton's neuroma
What does Morton's neuroma mean?
Morton's neuroma is a condition that affects the foot, causing pain and discomfort in the toes.
If you're looking for an effective solution to relieve pain and regain your ability to walk comfortably, surgery may be the right solution for you. On this page, you'll find detailed information about Morton's neuroma surgery, including:
• What does Morton's neuroma surgery involve? A detailed description of the procedure, from preparation for surgery to the recovery phase.
• Types of surgery: Illustration of the different surgical techniques used for the removal of Morton's neuroma.
• Benefits and risks: Analysis of the advantages and disadvantages of the intervention, including possible side effects.
• What to expect after surgery: Information on the post-operative recovery journey, from pain management to physiotherapy.
The history of interdigital neuroma, better known as Morton's neuroma, is quite long and complex. The condition was first described in 1845 by Lewis Durlacher, surgeon to the Queen of England. In 1876, T.G. Morton suspected that the problem was related to the presence of a neuroma, or some type of hypertrophy of the digital branches of the lateral plantar nerve at the level of the fourth metatarsophalangeal joint.
Modern biomechanical and anatomical-pathological knowledge leads us to consider interdigital neuroma as a painful clinical entity involving the common digital nerve.
What causes Morton's neuroma?
Morton's neuroma forms between the 3rd and 4th metatarsal due to the particular anatomical characteristics that the nerve has in that particular region and its relationship with the metatarsal bones which create compression, rather than being a true neuroma which would be an increase in the size of the nerve.
It is therefore a “neurogenic metatarsalgia”, that is, caused by the anatomical or functional alteration of one or more nerves and is a pathology clearly distinct from biomechanical metatarsalgia.
The most common symptom of an interdigital neuroma is pain localized to the third and fourth toes.
The pain usually manifests as a burning, stabbing sensation, and may also feel like tingling or an electric shock in about 60% of cases. The symptom complex is aggravated by foot activity, and the pain most often occurs when the patient wears a shoe with a narrow toe box.
This pain is often relieved by removing the shoe and rubbing the forefoot.
Sometimes, wearing a loose, soft, walking or jogging shoe results in a significant reduction in symptom complex. The symptom complex of neurogenic metatarsalgia is very similar to the symptoms of biomechanical metatarsalgia.
Morton's neuroma: diagnosis
To understand if you have Morton's neuroma, a specialist visit is essential. The doctor, by carrying out specific tests and observing the patient walking barefoot and observing the possible presence of calluses or hyperkeratosis, can formulate a diagnosis.
A simple test you can perform at home is called the Mulder test. If you squeeze all five metatarsals with your hand, you'll feel a snap, a click, and a sharp jolt localized between the third and fourth toes.
Once the presence of much more common pathologies has been ruled out, such as hallux valgus and hallux rigidus, which can cause biomechanical metatarsalgia, the surgeon is often already able to formulate a diagnosis.
Electrodiagnostic studies are not helpful unless peripheral neuropathy is suspected.
Weight-bearing X-rays are useful for identifying bone or joint pathology.
Magnetic resonance imaging (MRI) may be useful in some cases to exclude other pathologies, but it is not sufficient to establish the diagnosis.
Likewise, ultrasound can be useful in some situations, but the rate of false positives and negatives is too high.
Morton's Neuroma: Conservative Treatment
Conservative treatment of Morton's neuroma often gives poor results as there is no effective therapy to "flame" the neuroma and reduce its size other than removing it.
Radiofrequency ablation and alcohol injections have been proposed as less traumatic methods in the treatment of neuromas.
Occasionally, the physical findings of pain, localized in the involved interspace, improve, but most patients continue to have symptoms and, over time, excision of the neuroma becomes necessary.
The goal of SmartHallux
The goal of SmartHallux is to revolutionize the treatment of all the most common foot and ankle pathologies and guarantee you a quick, reliable and above all long-lasting solution. To achieve this goal we adopt the best surgical techniques, orthopedic devices, instruments and materials on the market.
We offer private healthcare at an affordable and affordable cost. Unfortunately, public and private healthcare systems have spending limits that limit the use of materials, equipment, and facilities.
With SmartHallux you will have access to the best possible treatments, in excellent facilities and without having to wait for public health authorities. Surgical techniques have undergone an important evolution compared to the past, starting from anesthesia and post-operative pain control.
Our surgical techniques
Anesthesia
The anesthesia that we use at SmartHallux does not involve painful ankle punctures or annoying spinal anesthesia or general anesthesia. With ultrasound guidance, our anesthetists are able to identify the nerves and with a single puncture behind the knee they are able to selectively "put to sleep" the nervous structures necessary and sufficient to perform the operation without pain, leaving the mobility of the legs and bladder control to the patient.
Sedation allows the patient to avoid anxiety and often wake up immediately after surgery. This type of anesthesia also allows for anesthesia to be prolonged for up to 24-48 hours, reducing or even eliminating postoperative pain, without any risks or contraindications.
The intervention
Through a small incision on the back of the foot, Morton's neuroma, the portion of the nerve affected by the pathological process, is removed.
The operation, which is usually performed as a day surgery, allows for a rapid recovery and immediate walking, wearing a common
comfortable footwear.
Rehabilitation after Morton's neuroma surgery plays a minor role, as tendons, bones, or joints are not affected, but only the interdigital nerve is removed.
Morton's neuroma: postoperative course
The stitches are removed two weeks after surgery. During these first two weeks, it's best to avoid excessive strain on the foot to aid the healing process, but walking and driving are possible.
Approximately 6 weeks after surgery, the patient can return to wearing normal shoes and carrying out normal physical and work activities.
Complications and risks of the surgery
The risks and complications associated with Morton's neuroma surgery are very rare, especially with noninvasive surgery. They include bleeding, allergic reactions, infections, deep vein thrombosis, embolisms, and skin complications, nerve damage with loss of sensation, persistent pain at the scar, delayed union, pseudoarthrosis, and joint stiffness.
The use of antibiotics and low molecular weight heparin further reduces the risk of complications.
Why choose SmartHallux for Morton's neuroma surgery?
SmartHallux is a clinic specializing in foot and ankle surgery, directed by Dr. Luigi Manzi, an internationally renowned orthopedic surgeon.
We offer a high quality service with a personalized approach, ensuring:
• Cutting-edge surgical techniques: We use the most innovative and least invasive techniques for the removal of Morton's neuroma.
• Highly qualified medical team: Our team of surgeons and anesthetists are highly specialized in foot and ankle surgeries.
• Rapid and safe recovery: Thanks to a personalized rehabilitation path, our patients can return to their daily activities in a short time.
• Competitive costs: We offer competitive prices compared to other clinics, without sacrificing quality of service.
Book your visit today
If you have Morton's neuroma and want to learn more about surgery, contact us today to schedule a consultation with Dr. Luigi Manzi.
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