Considerations in the Diagnosis and Treatment of Morton’s Entrapment: A Review

• Type of Material: Article
• Authors: Gabriel Santamarina, Emory University; George Zislis, Emory University
• Language: English
• Date: 2020-10-12
• Publisher: Research Open
• Publication Version: Final Published Version
• Copyright Statement: © Copyrights are reserved
• Final Published Version (URL): http://dx.doi.org/10.31038/IJOT.2020331
• Title of Journal or Parent Work: Integrative Journal of Orthopaedics and Traumatology
• Volume: 3
• Issue: 3
• Research Categories: Health Sciences, Medicine and Surgery; Biology, Neuroscience

Abstract

Intermetatarsal neuromas, known by their eponym as Morton’s neuromas, are a common painful forefoot pathology seen in the foot and ankle clinic. The nomenclature of this condition is misleading. The term “neuroma” refers to a non-degenerative nerve injury. The condition clinicians most often describe in a “Morton’s neuroma” is more accurately described as a perineural fibrosis of the plantar interdigital nerve leading to entrapment of this nerve [1]. Surgical treatment varies from entrapment release to full neurectomy [2]. Post-operative pathology review of neurectomized tissue rarely demonstrates axonal degeneration and collagen proliferation [3]. Those changes are the pathophysiological markers associated with nerve injury that lead to true neuroma formation. The authors, therefore, recommend changing the common name of the condition from “intermetatarsal neuroma” to interdigital nerve entrapment to better define the disease. The aim of this review is to present treatment schemes seen in “Morton’s” diagnosis, and to suggest an algorithm which may improve patient outcome.