Morton??s Neuroma-Pathogenesis and Ultrastructure

Treatment of intermetatarsal Morton?s neuroma with alcohol injection under US guide: 10-month follow-up

“…Many authors believe that an excessively pronated foot and cavus feet are usually implicated because of the increased tension on the plantar fascia and the intermetatarsal ligament [5,6,7,8].…”

Neuropeptide- and tyrosine hydroxylase-immunoreactive nerve fibers in painful Morton's neuromas

“…2,28 However, some authors report that inflammatory changes are rare or absent in their material. 14,24 Obliterative vascular changes may also contribute to the pathophysiology, by causing ischemia with subsequent injury to the nerve. However, because such vascular changes are common in control groups and some investigators find no evidence of ischemic injury, the role of ischemia in pathogenesis is still unclear.…”

“…However, because such vascular changes are common in control groups and some investigators find no evidence of ischemic injury, the role of ischemia in pathogenesis is still unclear. 14,19,24 Histological, immunocytochemical, and ultrastructural investigations of MN have demonstrated extensive fibrosis of the affected nerve. 13,20 Other frequent findings are endoneurial edema, demyelination, and axonal injury or loss.…”

“…4,[24][25][26] Vascular changes have also been reported. 12,14 A number of studies in both animals and humans have shown that injured neural tissue of the neuroma type contains a large number of arrested axonal nerve endings. Many of these nerve fibers generate impulses spontaneously and become very sensitive to mechanical as well as chemical stimuli.…”

Die intermetatarsale Neuropathie – Civinini-Durlacher, genannt Morton Metatarsalgie

“…Ein intestistielles Ödem, Verdickungen, Fibrosierung und reparatives, überschießendes Wachstum des endoneuralen und perineuralen Bindegewebes, sowie die Schädigung der großen markhaltigen Nervenfasern sind die Folge, die marklosen Schmerzfasern bleiben länger erhalten. Die Dauerbelastung durch Übergewicht und Hyperextension der MTPGelenke im hochhackigen Schuhwerk und Fußstatik-variationen mit Abknickung des Nerven am Ligamentum metatarseum transversum scheinen die Mikrotraumatisierung zu begünstigen [12,15].…”