Morton's neuroma surgery: Difference between revisions
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==Overview== | ==Overview== | ||
[[Surgery]] is the last resort in the [[Treatments|treatment]] of [[morton's neuroma]]. In some cases, [[surgery]] may be needed to remove the [[Thickener|thickened]] [[tissue]]/[[Affect|affected]] [[nerve]] in order to [[Help Menu|help]] [[Release (information centre)|release]] the [[pressure]] on the [[Affect|affected]] [[nerve]], [[Pain relief|relieve]] the [[pain]] and [[Improving agent|improve]] [[foot]] [[Function (biology)|function]]. [[ | [[Surgery]] is the last resort in the [[Treatments|treatment]] of [[morton's neuroma]]. In some [[Case-based reasoning|cases]], [[surgery]] may be needed to remove the [[Thickener|thickened]] [[tissue]]/[[Affect|affected]] [[nerve]] in order to [[Help Menu|help]] [[Release (information centre)|release]] the [[pressure]] on the [[Affect|affected]] [[nerve]], [[Pain relief|relieve]] the [[pain]] and [[Improving agent|improve]] [[foot]] [[Function (biology)|function]]. [[Fewmets|Few]] [[complications]] [[after surgery]] are possible and include [[Permanent cosmetics|permanent]] nonpainful [[numbness]] if a [[Portion control (dieting)|portion]] of the [[Affect|affected]] [[nerve]] is removed, [[RiskMetrics|risk]] of [[Postoperative complication|postoperative]] [[infection]] around the [[toes]], [[Incision|incisional]] [[Sore|soreness]], [[scarring]], and [[Recurring dream|recurring]] stump [[Neuroma|neuromas.]] [[Morton's neuroma]] can be removed [[Surgery|surgically]] either via [[dorsal]] or [[plantar]] approach, with each approach having its own merits and demerits. [[Dependency ratio|Depending]] upon each [[Individual growth|individual]] [[Case-based reasoning|case]], [[Differentiate|different]] [[surgical procedures]] that can be [[Usage analysis|used]] for the [[Treatments|treatment]] of [[morton's neuroma]] include [[neurectomy]], [[cryogenic]] [[surgery]]/neuroablation, and [[decompression]] [[surgery]]. | ||
==Surgery== | ==Surgery== | ||
* [[Surgery]] is the last resort in the [[Treatments|treatment]] of [[morton's neuroma]] | * [[Surgery]] is the last resort in the [[Treatments|treatment]] of [[morton's neuroma]] and is advised when: | ||
* In some cases, [[surgery]] may be needed to remove the [[Thickener|thickened]] [[Tissue (biology)|tissue]]/[[Affect|affected]] [[nerve]] in order to [[Help Menu|help]]: | ** Other [[Therapy|therapies]] have [[Failure|failed]] | ||
** [[Release (information centre)|Release]] the [[pressure]] on the [[Affect|affected]] [[nerve]] by [[Wide and fast|widening]] the [[Space medicine|space]] through which the [[Affect|affected]] [[nerve]] travels | ** [[Symptoms]] persist [[Afterimage|after]] 9 to 12 months | ||
* In some [[Case-based reasoning|cases]], [[surgery]] may be needed to remove the [[Thickener|thickened]] [[Tissue (biology)|tissue]]/[[Affect|affected]] [[nerve]] in order to [[Help Menu|help]]:<ref name="pmid20539960">{{cite journal| author=Zanetti M, Saupe N, Espinosa N| title=Postoperative MR imaging of the foot and ankle: tendon repair, ligament repair, and Morton's neuroma resection. | journal=Semin Musculoskelet Radiol | year= 2010 | volume= 14 | issue= 3 | pages= 357-64 | pmid=20539960 | doi=10.1055/s-0030-1254524 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20539960 }} </ref> | |||
**[[Release (information centre)|Release]] the [[pressure]] on the [[Affect|affected]] [[nerve]] by [[Wide and fast|widening]] the [[Space medicine|space]] through which the [[Affect|affected]] [[nerve]] travels | |||
** [[Pain relief|Relieve the pain]] | ** [[Pain relief|Relieve the pain]] | ||
** [[Improving agent|Improve]] [[foot]] [[Function (biology)|function]] | ** [[Improving agent|Improve]] [[foot]] [[Function (biology)|function]] | ||
===Complications after the surgery=== | |||
* If a portion of the [[Affect|affected]] [[nerve]] is removed during the [[surgery]], [[Permanent makeup|permanent]] [[numbness]] occurs between the [[toes]], but it's not [[painful]] | * If a portion of the [[Affect|affected]] [[nerve]] is removed during the [[surgery]], [[Permanent makeup|permanent]] [[numbness]] occurs between the [[toes]], but it's not [[painful]] | ||
* There is a small [[RiskMetrics|risk]] of [[infection]] around the [[toes]] [[after surgery]] | |||
*[[Incision|Incisional]] [[Sore|soreness]] | |||
*[[Scarring]] | |||
*[[Recurring dream|Recurring]] stump [[Neuroma|neuromas]] | |||
===Surgical Approaches=== | |||
Following [[Two-dimensional|two]] [[Surgery|surgical]] approaches can be [[Usage analysis|used]]: | |||
{| class="wikitable" | |||
|+Different surgical approaches | |||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Type of surgical approach}} | |||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Details}} | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |'''Dorsal approach''' | |||
| | |||
* [[Surgeon]] [[MakeBot|makes]] an [[incision]] on the [[Top7|top]] of the [[foot]] | |||
* As the [[Stitch|stitches]] are not on the [[weight]]-bearing [[Side chain|side]] of the [[foot]], this approach allows the [[patient]] to [[walk]] soon [[after surgery]] | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |'''Plantar approach''' | |||
| | |||
* [[Surgeon]] [[MakeBot|makes]] an [[incision]] on the [[sole of the foot]] | |||
* During [[recovery]], most [[patients]] will need to [[Usage analysis|use]] [[crutches]] for about 3 weeks | |||
* [[Result|Resulting]] [[scar]] might [[MakeBot|make]] [[walking]] [[Uncomfortable science|uncomfortable]] | |||
* Benefits of [[plantar]] approach includes: | |||
** It is easy to remove [[neuroma]] by this approach | |||
** [[Neuroma]] can be removed without [[Cut|cutting]] [[Any Question Answered|any]] [[Structure factor|structures]] | |||
|} | |||
===Surgical Procedures=== | |||
{| class="wikitable" | {| class="wikitable" | ||
|+Different surgical options for the treatment of Morton's neuroma | |+Different surgical options for the treatment of Morton's neuroma | ||
| Line 19: | Line 50: | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Neurectomy | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Neurectomy | ||
| | | | ||
* | * It involves the removal of a part of the [[nerve]] [[tissue]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Cryogenic surgery/Cryogenic neuroablation | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Cryogenic surgery/Cryogenic neuroablation | ||
| | | | ||
* | * It kills the [[nerves]] and the [[myelin sheath]] [[Cover test|covering]] them by [[Usage analysis|using]] [[Extreme value|extremely]] [[cold]] [[temperatures]] | ||
* Low [[Chance|chances]] of [[Recurrence plot|recurrence]] | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Decompression surgery | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Decompression surgery | ||
| | | | ||
* | * It relieves the [[pressure]] on the [[nerve]] by [[Cut|cutting]] the [[ligaments]] and other [[Structure factor|structures]] around the [[nerve]] | ||
|} | |} | ||
Latest revision as of 15:26, 21 June 2019
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Morton's neuroma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Morton's neuroma surgery On the Web |
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American Roentgen Ray Society Images of Morton's neuroma surgery |
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Risk calculators and risk factors for Morton's neuroma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]
Overview
Surgery is the last resort in the treatment of morton's neuroma. In some cases, surgery may be needed to remove the thickened tissue/affected nerve in order to help release the pressure on the affected nerve, relieve the pain and improve foot function. Few complications after surgery are possible and include permanent nonpainful numbness if a portion of the affected nerve is removed, risk of postoperative infection around the toes, incisional soreness, scarring, and recurring stump neuromas. Morton's neuroma can be removed surgically either via dorsal or plantar approach, with each approach having its own merits and demerits. Depending upon each individual case, different surgical procedures that can be used for the treatment of morton's neuroma include neurectomy, cryogenic surgery/neuroablation, and decompression surgery.
Surgery
- Surgery is the last resort in the treatment of morton's neuroma and is advised when:
- In some cases, surgery may be needed to remove the thickened tissue/affected nerve in order to help:[1]
Complications after the surgery
- If a portion of the affected nerve is removed during the surgery, permanent numbness occurs between the toes, but it's not painful
- There is a small risk of infection around the toes after surgery
- Incisional soreness
- Scarring
- Recurring stump neuromas
Surgical Approaches
Following two surgical approaches can be used:
| Type of surgical approach | Details |
|---|---|
| Dorsal approach | |
| Plantar approach |
|
Surgical Procedures
| Surgical procedure | Details of the procedure |
|---|---|
| Neurectomy | |
| Cryogenic surgery/Cryogenic neuroablation |
|
| Decompression surgery |
References
- ↑ Zanetti M, Saupe N, Espinosa N (2010). "Postoperative MR imaging of the foot and ankle: tendon repair, ligament repair, and Morton's neuroma resection". Semin Musculoskelet Radiol. 14 (3): 357–64. doi:10.1055/s-0030-1254524. PMID 20539960.