Morton’s Neuroma Excision

69 year old female with a painful neuroma. She had tried all conservative options (eg, orthotics, steroids, modified activities, neuroma pads) but was still having pain. Underwent neuroma excision and is 6 weeks out. She is doing well but has some soreness in the forefoot.

Typically, neuromas are common in the 3rd interspace (ie, between the 3rd and 4th toes). Surgery, when indicated, is usually performed with an incision on top of the foot. To access the neuroma the intermetatarsal ligament has to be incised. This is repaired after neuroma excision but usually is why patients have soreness for a few weeks and even a few months after surgery. Compression socks and orthotics help mitigate the symptoms.

Below is the MRI revealing the large 3rd interspace neuroma, the xrays show that even with repair there is some residual widening of the 3rd interspace, in this case was 0.7 mm. Finally, a photo of her healed incision.