A Prospective Randomized Controlled Trial of Plantar Versus Dorsal Incisions for Operative Treatment of Primary Morton’s Neuroma

Abstract

Level I, prospective randomized trial.

Excision of Morton’s Neuroma Using a Longitudinal Plantar Approach

“…18,47 These findings do not quite correlate with the low rate of scar-related problems (5.3%) in our series. In agreement with Karges, 19 the authors believe that hypertrophic scar formation may be avoided by slightly everting wound closure.…”

“…This does not match with previous studies, where the rate of scar-related problems was 15% to 27%. 18,42,47 This single-surgeon case series using a longitudinal plantar approach with standardized diagnostic examination, operative procedure, postoperative schedule, follow-up protocol, and histological confirmation in all cases may have the limitation of lacking a control group with dorsal approach. Furthermore, there could be a bias because the treating surgeon also did the follow-up examination.…”

Long-Term Results of Neurectomy Through a Dorsal Approach in the Treatment of Morton’s Neuroma

“…However, in a meta-analysis presented by Glasoe and Coughlin [31], the majority of authors recommend plantar approach rather than dorsal approach. On the other hand, in a trial comparing plantar and dorsal neurectomies, Akermerk et al found showed no differences in the results, but different types of complications [34]. In the current study, in order to avoid scars on the plantar side, the dorsal approach was used as recommended by Mann and Reynolds [35].…”

Nervenkompressionssyndrome

“…Arcuatum oder Lig. Sie reichen von 5 cm (Amadio und Beckenbaugh (1986); Doyle und Botte (2003); Green und Rayan (1999)) bis 12 cm distal des medialen Epicondylus (Siemionov et al 2007 Sonderformen sind lagerungsbedingte Schäden nach Narkosen oder bei chronisch Bettlägerigen (Sunderland 1978). Flexor-Pronator-Aponeurose mit variablen Bändern.…”

“…Eine prospektive randomisierte kontrollierte Studie verglich den dorsalen mit dem plantaren Zugang (Akermark et al 2013). Interdigitalnerv betroffen -Hypästhesie der angrenzenden Zehenhälften häufig, jedoch nicht obligat Neurografischer Befund -Sensible Neurografie technisch aufwendig Bildgebung -Im Sonogramm und mittels MRT Nachweis des Morton-Neurom's sowie anderweitiger raumfordernder Prozesse .…”