Morton’s neuroma
Indications- failed non-operative approaches after other causes excluded
Dorsal or plantar approach
Correct diagnosis
Scaring from plantar incision
Technique (dorsal approach):
• skin incision in distal intermetatarsal area- 3-4
• dissection to deep transverse intermetatarsal ligament; retract fatty tissue and preserve vessels
• dissect nerve
• transverse metatarsal ligament is cut tonsillar retractor to separate met heads
• nerve excised
• closure, with care to avoid dead space
Post-op- post-op shoe; sutures out at 3 weeks; toe flexion exercises
Complications- recurrence; stump neuroma
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