Skip to main content
SpringerLink
Log in

Morton’s Neuroma

  • Reference work entry
  • First Online:
European Surgical Orthopaedics and Traumatology

  • 373 Accesses

Abstract

Interdigital neuroma is a clinical syndrome of the forefoot causing pain and disability and it is considered to be one of the most common causes of forefoot pain. A large number of studies have been performed concerning neuromata over time, nevertheless, causes and ideal treatment are still under debate.

Conservative treatment is firstly to be attempted, while the indication for surgery, in a patient affected by a Morton’s neuroma, is essentially clinical and relies on neurolysis or neurectomy.

Complications due to surgical treatment are few and the literature is consistent with a rate of clinical success around 80 %. Newer mini-invasive/infiltrative procedures are still to be further investigated.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 649.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 949.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Guiloff RJ, Scadding JW, Klenerman L. Morton’s metatarsalgia: clinical, electrophysiological and histological observations. J Bone Joint Surg. 1984;66-B(4):586–91.

    Google Scholar 

  2. Mann RA. Disease of the nerves. In: Coughlin MJ, Mann RA, editors. Surgery of foot and ankle, vol. 1. 7th ed. St. Louis: Mosby; 1999. p. 502–24.

    Google Scholar 

  3. Viladot A. Metatarsalgia due to biomechanical alterations of the forefoot. Orthop Clin North Am. 1973;4(1):165–78.

    CAS  PubMed  Google Scholar 

  4. Thomson C, Campbell R, Wood A, Rendall G. Disorders of the adult foot. In: Lorimer DL et al., editors. Neale’s disorder of the foot. 6th ed. Edinburgh: Churchill Livingstone; 2001.

    Google Scholar 

  5. Interventions for the treatment of Morton’s neuroma (review) Copyright 2009 The Cochrane Collaboration. Wiley.

    Google Scholar 

  6. Civinini F. Su d’un nervoso gangliare rigonfiamento alla pianta del piede. Pistoia: Lettera anatomica; 1835.

    Google Scholar 

  7. Dangnall JC. Lewis Durlacher. Surgeon-Chiropodist (1792–1864). Med Hist. 1958;2:68–9.

    Article  Google Scholar 

  8. Morton TG. A peculiar and painful affliction of the fourth metatarsophalangeal joint articulation. Am J Med Sci. 1876;71:37–45.

    Article  Google Scholar 

  9. Hauser EDW. Diseases of the foot. Philadelphia/London: WB Saunders; 1939. p. 472.

    Google Scholar 

  10. Betts LO. Morton’s metatarsalgia: neuritis of the fourth digital nerve. Med J Aust. 1940;1:514.

    Google Scholar 

  11. Graham CE, Graham DM. Morton’s neuroma: a microscopic evalouation. Foot Ankle. 1984;5:150.

    Article  CAS  PubMed  Google Scholar 

  12. Green WB. Netter’s ortthopaedics. Morton Neuroma. Elsevier science; 2007. p. 445–6.

    Google Scholar 

  13. Weinfeld SB, Myerson M. Interdigital neuritis: dagnosis and treatment. J Am Acad Orthop Surg. 1996;4(6):328–35.

    PubMed  Google Scholar 

  14. Jones JR, Klenerman L. A study of the communicating branch between the medial and lateral planter nerves. Foot Ankle. 1984;4(6):313–7.

    Article  CAS  PubMed  Google Scholar 

  15. Mann RA, Reynolds JC. Interdigital neuroma: a critical clinical analysis. Foot Ankle. 1983;3(4):238–43.

    Article  CAS  PubMed  Google Scholar 

  16. Levitsky KA, Alman BA, Jesevar DS, Morehead J. Digital nerves of the foot: anatomic variations and implications regarding the pathogenesis of the interdigital neuroma. Foot Ankle. 1993;14(4):208–14.

    Article  CAS  PubMed  Google Scholar 

  17. Pace A, Scammell B, Dhar S. The outcome of Morton’s neurectomy in the treatment of metatarsalgia. Int Orthop. 2010;34(4):511–5.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Hassouana H, Singh D. Morton’s metatarsalgia: pathogenesis, aetiology and current menagment. Acta Orthop Belg. 2005;71(6):646–55.

    Google Scholar 

  19. Nissen KI. Plantar digital neuritis: Morton’s metatarsalgia. J Bone Joint Surg Br. 1948;30:84.

    Google Scholar 

  20. Kim JY, Choi JH, Park J, Wang J, Lee I. An anatomical study of Morton's interdigital neuroma: the relationship between the occurring site and the deep transverse metatarsal ligament (DTML). Foot Ankle Int. 2007;28(9):1007–10.

    Article  PubMed  Google Scholar 

  21. Giannini S, Bacchini P, Ceccarelli F, Vannini F. Interdigital neuroma: clinical examination and histopathologic results in 63 cases traeted with exicision. Foot Ankle Int. 2004;25:79–84.

    PubMed  Google Scholar 

  22. Viladot A. Morton’s neuroma. Int Orthop. 1992;16:294–6.

    Article  CAS  PubMed  Google Scholar 

  23. Bossley CJ, Cairney PC. The intermetatarsophalangeal bursa: its significance in Morton’s metatarsalgia. J Bone Joint Surg. 1980;62-B:184–7.

    CAS  Google Scholar 

  24. Coughlin MJ, Mann RA. Surgery of foot and ankle. Compressive neuropathies of the foot and ankle. Plantar interdigital neuroma. 8th edn. p. 825–33.

    Google Scholar 

  25. Biasca N, Zanetti M, Zollinger H. Outcomes after partial neurectomy of Morton’s neuroma related to preoperative case histories, clinical findings, and findings on magnetic resonance imaging scans. Foot Ankle Int. 1999;20(9):568–75.

    Article  CAS  PubMed  Google Scholar 

  26. Mulder JD. The causative mechanism in Morton’s metatarsalgia. J Bone Joint Surg Br. 1951;33:94–5.

    PubMed  Google Scholar 

  27. Gauthier G. Thomas Morton’s disease: a nerve entrapment syndrome. A new surgical technique. Clin Orthop Relat Res. 1979;142:90–2.

    PubMed  Google Scholar 

  28. Bratkowski B. Differential diagnosis of plantar neuromas: a preliminary report. J Foot Ankle Surg. 1978;17:99–102.

    CAS  Google Scholar 

  29. Mi-Jung L, Sungjun K, Yong-Min H, Ho-Teak S, Sung-Ah L, Jin Woo L, Jin- Suck S. Morton Neurona : evaluated with ultrasono graphy and MRI. Korean J Radiol. 2007;8:148–55.

    Article  Google Scholar 

  30. Studler U, Mengiardi B, Bode B, Schottle PB, Pfirrmann CWA, Hodler J, Zanetti M. Fibrosis and Sdventitious Bursae in plantar fat pad of forefoot: MR imaging findings in asymptomatic volunteers and MR imaging-histologic comparison. Radiology. 2008;246(3):863–70.

    Article  PubMed  Google Scholar 

  31. Weishaupt D, Treiber K, Kundert HP, Zollinger H, Vienne P, Hodler J, Willmann JK, Marincek B, Zanetti M. Morton neuroma: MR imaging in prone, supine, and upringht weight-bearing body positions. Radiology. 2003;226(3):849–56.

    Article  PubMed  Google Scholar 

  32. Haddad-Zebouni S, Aoun N, Okais J, Ghossain M. Regression of Morton neuroma after local injection of steroids. Radiology. 2006;87:566–8.

    Article  CAS  Google Scholar 

  33. Bennet GL, Graham CE, Maudlin DM. Morton’s interdigital neuroma: a comprehensive treatment protocol. Foot Ankle Int. 1995;16(12):760–3.

    Article  Google Scholar 

  34. Greenfield J, Rea J, Ilfield F. Morton’s interdigital neuroma: indications for treatment by local injections versus surgery. Clin Ortho Relat Res. 1984;185:142–4.

    Google Scholar 

  35. Rasmussen CE, Neal RM, Hinton GE, Camp D van, Revow M, Ghahramani Z, Kustra R, Tibshrani R. The DELVE manual; 1996.

    Google Scholar 

  36. Gaynor R, Hake D, Spinner SM, Tomczak RL. A comparative analysis of conservative versus surgical treatment of Morton’s neuroma. J Am Podiatr Med Assoc. 1989;79(1):27–30.

    Article  CAS  PubMed  Google Scholar 

  37. Basadonna P, Rucco V, Gasparini D, Onorato A. Plantar fat pad atrophy after corticosteroid injection for an interdigital neuroma. A case report. Am J Phys Med Rehabil. 1999;78(3):283–5.

    Article  CAS  PubMed  Google Scholar 

  38. Reddy PD, Zelicof SB, Ruotolo C, Holder J. Interdigital neuroma: local cutaneus changes after corticosteroid injection. Clin Orthop Relat Res. 1995;317:185–7.

    PubMed  Google Scholar 

  39. Glasoe WM, Coughlin MJ. A critical analysis of Dudley. Morton’s concept of disordered foot function. J Foot Ankle Surg. 2006;45(3):147–55.

    Article  PubMed  Google Scholar 

  40. Villas C, Florez B, Alfonso M. Neurectomy versus neurolysis for Morton’s neuroma. Foot Ankle Int. 2008;29(6):578–80.

    Article  PubMed  Google Scholar 

  41. Zelent ME, Kane RM, Neese DJ, Lockner WB. Minimally invasive Morton’s intermetatarsal neuroma decompression. Foot Ankle Int. 2007;28(2):263–5.

    Article  PubMed  Google Scholar 

  42. Banks AS, Vito GR, Giorgini TL. Recurrent intermetatarsal neuroma: a followup study. J Am Podiatr Med Assoc. 1996;86:299–306.

    Article  CAS  PubMed  Google Scholar 

  43. Cabaud HE, Rodkey WG, Nemeth TJ. Progressive ultrastructural changes after peripheral nerve transection and repair. J Hand Surg. 1982;7:353–65.

    Article  CAS  Google Scholar 

  44. Williams HB. The painful stump neuroma and its treatment. Clin Plast Surg. 1984;11:79–83.

    CAS  PubMed  Google Scholar 

  45. Shapiro SL. Endoscopic decompression of the intermetatarsal nerve for Morton’s neuroma. Foot Ankle Clin. 2004;9:397–07.

    Article  Google Scholar 

  46. Barrett SL, Pignetti TT. Endoscopic decompression for intermetatarsal nerve entrapment. J Foot Ankle Surg. 1996;86:299–306.

    Google Scholar 

  47. Amis JA, Siverhus SW, Liwnicz BH. An anatomic basis for recurrence after Morton’s neuroma excision. Foot Ankle. 1992;13:153–6.

    Article  CAS  PubMed  Google Scholar 

  48. Haddad SL. Compressive neuropathies of the foot and ankle. In: Myerson M, editor. Foot and ankle disorders, vol. 2. Philadelphia: WB Saunders; 2000. p. 825–30.

    Google Scholar 

  49. Ronconi P, Arati E, Baleanu PM, Ragonesi P, Stasolla D, Arcioni R. Neuroma di Morton: “Decompressione endoscopica”. Tecnica di Carretmodificata con alcolizzazione. Foot medical hospital of Rome.

    Google Scholar 

  50. Yamamoto T, Akisue T, Kurosaka M, Mizuno K, Mukai H. Elastofibroma in shoulder osteoarthritis: a theoretical concept of the etiology. Clin Orthop. 2001;387:127–31.

    Article  PubMed  Google Scholar 

  51. Kaplan EB. Surgical approach to the plantar digital nerves. Bull Hosp Joint Dis. 1950;11:96–7.

    CAS  PubMed  Google Scholar 

  52. McElvenny RT. The etiology and surgical treatment of intractable pain about the fourth metatarsophalangeal joint (Morton’s toe). J Bone Joint Surg Am. 1943;25:675–9.

    Google Scholar 

  53. McKeever DC. Surgical approach for neuroma of plantar nerve (Morton’s metatarsalgia). J Bone Joint Surg Am. 1952;34:490.

    PubMed  Google Scholar 

  54. Akermark C, Crone H, Saartok T, Zuber Z. Plantar versus dorsal incision in the treatment of primary intermetatarsal Morton’s neuroma. Foot Ankle Int. 2008;29(2):136–41.

    Article  PubMed  Google Scholar 

  55. Magnan B, Marangon A, Frigo A, Bartolozzi P. Local phenol injection in the treatment of interdigital neuritis of the foot (Morton’s neuroma). Chir Organi Mov. 2005;90(4):371–7.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Istituto Ortopedico Rizzoli, Bologna, Italy

    Sandro Giannini, M. Cadossi, D. Luciani & F. Vannini

Authors
  1. Sandro Giannini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Cadossi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Luciani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. Vannini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sandro Giannini .

Editor information

Editors and Affiliations

  1. Royal National Orthopaedic Hospital, Stanmore, United Kingdom

    George Bentley

Rights and permissions

Reprints and permissions

Copyright information

© 2014 EFORT

About this entry

Cite this entry

Giannini, S., Cadossi, M., Luciani, D., Vannini, F. (2014). Morton’s Neuroma. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-34746-7_149

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-34746-7_149

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-34745-0

  • Online ISBN: 978-3-642-34746-7

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation