The Journal of Bone and Joint Surgery, Vol 70, Issue 5 651-657, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc
Persistent pain after excision of an interdigital neuroma. Results of reoperation
JE Johnson, KA Johnson and KK Unni
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905.
Thirty-four patients (thirty-seven feet) had a reoperation for pain that
persisted after excision of a plantar interdigital (Morton) neuroma. A
longitudinal plantar incision was used in thirty-three feet and the
previous dorsal web-space incision was used in four feet. Of the
thirty-nine pathological specimens that were obtained intraoperatively,
twenty-six (67 per cent) contained elements either of primary interdigital
neuroma tissue or of an interdigital neuroma in association with an
amputation-stump neuroma, indicating that the recurrent pain in these
patients had probably resulted from an incomplete initial excision. All but
one of the thirty-four patients were available for follow-up at an average
of seventy-six months (range, ten to 124 months) postoperatively.
Twenty-two patients (67 per cent) had complete relief from or marked
improvement in pain, three (9 per cent) had improvement but had persistent
pain, and eight (24 per cent) had no improvement or had worse pain. The
longitudinal plantar incision was satisfactory in all but one patient and
did not result in a painful plantar scar. The number of previously
unsuccessful attempts that had been made to excise the neuroma did not
adversely affect the results of reoperation in this group of patients.
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