Open excision vs. percutaneous intermetatarsal ligament release for Morton's neuroma: A comparative analysis - Is width important?

IF 1.9 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2025-03-06 DOI:10.1016/j.fas.2025.02.016

Emanuel Cortesão Seiça, João Seixas, Alexei Buruian, Daniel Peixoto, Primoz Potocnik, João Vide

{"title":"Open excision vs. percutaneous intermetatarsal ligament release for Morton's neuroma: A comparative analysis - Is width important?","authors":"Emanuel Cortesão Seiça, João Seixas, Alexei Buruian, Daniel Peixoto, Primoz Potocnik, João Vide","doi":"10.1016/j.fas.2025.02.016","DOIUrl":null,"url":null,"abstract":"Background: Morton's interdigital neuroma, caused by compression of the interdigital nerve, often requires surgery when conservative treatment fail. This study compared open neurectomy and percutaneous intermetatarsal ligament release (PILR), focusing on various predictive factors.Methods: A retrospective study, comprising 46 patients (58 feet) with Morton's neuroma who underwent either open excision (n = 24) or PILR (n = 22) from 2012 to 2022. Data included demographics, MRI-measured neuroma size, complications, and revision surgery. Outcomes were assessed using the Visual Analog Scale (VAS), Foot and Ankle Ability Measure (FAAM), and satisfaction scores.Results: Open excision yielded better outcomes than PILR for neuromas larger than 7.40 mm, with lower VAS scores (2.3 vs. 3.9), higher FAAM scores (87 vs. 72), and greater satisfaction (3.2 vs. 2.1). Neuroma width predicted outcomes in the PILR group.Conclusion: Open excision is superior for larger neuromas, while PILR may suit smaller ones (<7.40 mm).Level of evidence: Level III cohort study CLINICAL RELEVANCE: This study highlights the importance of neuroma width in determining the success of percutaneous intermetatarsal ligament release (PILR). Our findings suggest that PILR may be more appropriate for smaller neuromas (<7.40 mm), while open excision offers better outcomes for larger neuromas. This insight could guide surgeons in selecting the most suitable surgical approach, optimizing patient outcomes, and minimizing complications.","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Foot and Ankle Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.fas.2025.02.016","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Morton's interdigital neuroma, caused by compression of the interdigital nerve, often requires surgery when conservative treatment fail. This study compared open neurectomy and percutaneous intermetatarsal ligament release (PILR), focusing on various predictive factors.

Methods: A retrospective study, comprising 46 patients (58 feet) with Morton's neuroma who underwent either open excision (n = 24) or PILR (n = 22) from 2012 to 2022. Data included demographics, MRI-measured neuroma size, complications, and revision surgery. Outcomes were assessed using the Visual Analog Scale (VAS), Foot and Ankle Ability Measure (FAAM), and satisfaction scores.

Results: Open excision yielded better outcomes than PILR for neuromas larger than 7.40 mm, with lower VAS scores (2.3 vs. 3.9), higher FAAM scores (87 vs. 72), and greater satisfaction (3.2 vs. 2.1). Neuroma width predicted outcomes in the PILR group.

Conclusion: Open excision is superior for larger neuromas, while PILR may suit smaller ones (<7.40 mm).

Level of evidence: Level III cohort study CLINICAL RELEVANCE: This study highlights the importance of neuroma width in determining the success of percutaneous intermetatarsal ligament release (PILR). Our findings suggest that PILR may be more appropriate for smaller neuromas (<7.40 mm), while open excision offers better outcomes for larger neuromas. This insight could guide surgeons in selecting the most suitable surgical approach, optimizing patient outcomes, and minimizing complications.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.