Dorsal Suspension for Morton's Neuroma: A Comparison with Neurectomy. Issue 3 (14th September 2018)

• Record Type: Journal Article
• Authors: Kang, Chan; Song, Jae-Hwang; Ahn, Ki jun; Choi, Bo Sung; Hwang, Sungjin; Lee, Gi-Soo; Lee, Jeong-kil; Seo, Gangwon; Kim, Dong Yeol
• Is Part Of: Foot & ankle orthopaedics. Volume 3:Issue 3(2018)
• Publication Date: 2018-09-14
• Subjects: Morton's neuroma -- neurectomy -- dorsal suspension -- dorsal transverse ligament; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Orthopedics -- Periodicals; 617.584
• DOI: 10.1177/2473011418S00281
• Languages: English
• ISSNs: 2473-0114

Abstract

Category: Midfoot/Forefoot Introduction/Purpose: We performed a dorsal suspension of neuroma using the dorsal transverse ligament for the treatment of Morton's neuroma. The purpose of this study was to investigate and compare the functional outcomes and complications of dorsal suspension with those of neurectomy. Methods: We conducted a retrospective study of thirty-eight (40 feet, 40 neuromas) and thirty-six (36 feet, 36 neuromas) patients who underwent dorsal suspension and neurectomy, respectively. At twenty-four month follow-up, the visual analog scale was used to evaluate pain, and the Foot and Ankle Ability Measure (FAAM) was used to investigate patient-reported function of activities of daily living and sports. Satisfaction analysis was performed using the Coughlin scale, and postoperative complications were also evaluated. Results: Both groups reported significant pain relief, and there were no significant differences between the groups with respect to postoperative pain (dorsal suspension group, mean, 12.0; neurectomy group, mean, 25.8; p = .99). The postoperative FAAM outcomes showed no significant between-group differences in activities of daily living (dorsal suspension group, mean, 89.5, neurectomy group, mean, 77.2; p = .22) or sports subscales (dorsal suspension group, mean, 85.5; neurectomy group, mean, 69.4; p = .97). Satisfaction analysis showed 'excellent' and 'good' results in the dorsal suspension and neurectomy groups (95% and 77.7%, respectively). Complications reported in the dorsal suspension and neurectomy groups were numbness (5% vs 61.1%, respectively, p < .05) and paresthesia (5% vs 33.3%, respectively, p < .05). Conclusion: Compared with neurectomy, dorsal suspension provided comparable pain relief and improvement in terms of functional outcomes, as measured by the FAAM. With its lower rate of complication and high satisfaction, dorsal suspension can be another operative option for the treatment of Morton's neuroma.