Morton’s neuroma

Based on the clinical findings ! Ultrasound MRI
Treatment Conservative Shoe modification : Shock attenuation to the forefoot region


Diagnosis Symptoms

Unique anatomy Increased thickness of common digital nerve to 3rd interspace

Interdigital neuroma = Morton’s neuroma Entrapment of the interdigital nerve

Treatment Surgical Dorsal approach prevention of scar formation on the plantar aspect

 Interdigital neuroma
= Morton’s neuroma 
Entrapment of the interdigital nerve 
Near the transverse intermetatarsal ligament 

Incidence
3rd web space > 2nd web space > Rarely others 
More common in Female (8:1)

Neuroma ?
(X) proliferation of axons
(O) deposition of hyaline and collagenous material  Degenration !  
Interdigital neuralgia or neuritis 


Unique anatomy 
Increased thickness of common digital nerve to 3rd interspace

Diagnosis 
Symptoms
Burning or cramping pain localized to the plantar aspect 
Increased with walking
Relieved by rest, removing shoe and rubbing 
Subjective numbness of toes

Signs
Mulder’s click
Palpable or audible click with pain reproducing

Based on the clinical findings !
Ultrasound
MRI 

Morton’s neuroma
Treatment 
Conservative 
Shoe modification : Shock attenuation to the forefoot region
Wide, soft, low-heel shoes
Soft metatarsal support or Metatarsal bar
Rocker sole 
Steroid injection
Medication
Treatment
Surgical 
Dorsal approach 
 prevention of scar formation on the plantar aspect 
Release the intermetatarsal ligament 
Neurectomy 
Proximal to the weight bearing area 
3cm proximal to the neuroma
Dorsal placement of nerve stump in the interosseous muscles 

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