Plantar approach for treatment of brachymetatarsia: A novel approach with an aesthetic consideration

Zhang, Ning; Xu, Hua shan; Zheng, Hongbo; Wang, Yang; Li, Zhengxun; Xu, Wei; Hu, Yong

doi:10.1016/j.bjps.2021.11.078

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…A questionnaire called appearance index (AI) was also used to assess the influence of foot appearance on the quality of life. The AI consists of a questionnaire with five items that estimate the impact of foot appearance regarding the daily activities at public places, leisure, sexual life, work or school, and personal relationships, with four responses scored from 0 to 3, where 0 is the best score [ 14 ]. The complications were recorded during the follow-up.…”

Section: Methodsmentioning

confidence: 99%

Plantar and dorsal approaches for excision of morton’s neuroma: a comparison study

Ning²,

Li³

et al. 2022

BMC Musculoskelet Disord

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Background Morton’s neuroma is a painful enlargement of the plantar digital nerve between the metatarsal heads that causes pain of the forefoot. Several approaches have been used to treat Morton’s neuroma, each of them having distinct advantages and disadvantages. Objectives The purpose of this study was to investigate and compare the clinical outcomes of neurectomy in the treatment of Morton’s neuroma through plantar and dorsal approaches. Materials and methods A total of 20 patients with a mean age of 48.5 ± 13.0 years (range: 19–66 years) who underwent excision of a Morton’s neuroma that did not respond to conservative treatment were retrospectively analysed from June 2014 to June 2021. All the neurectomies were performed using a plantar or dorsal approach. Outcomes were evaluated using visual analogue scale (VAS) scores, American Orthopedic Foot and Ankle Society (AOFAS) scores, the Foot and Ankle Ability Measure (FAAM), and complications. The appearance index (AI) was also used to assess the influence of foot appearance on the quality of life after surgery. Results Eight patients underwent neurectomy by the dorsal approach, and 12 patients underwent neurectomy by the plantar approach. The average follow-up time was 28.9 ± 12.9 months (range: 15–72 months). No statistically significant difference was found between the dorsal and plantar approach groups with respect to postoperative pain measured by the VAS score. The postoperative AOFAS scores and FAAM outcomes were not significantly different between the groups. The complications reported in the dorsal approach group were significantly less than those of the plantar group, mainly discomfort in wearing shoes. The AI of the plantar group and the dorsal group were significantly different. Conclusion The excision of the Morton’s neuroma by both the dorsal and plantar approach resulted in satisfactory outcomes. However, the foot appearance after surgery by the plantar approach had less influence on the quality of life than that using the dorsal approach. Our recommendation is that surgeons should choose the approach they are most familiar with and with which they are most confident in performing. In addition, the plantar approach is recommended if the patient needs a better appearance.

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Section: Methodsmentioning

confidence: 99%

Plantar and dorsal approaches for excision of morton’s neuroma: a comparison study

Ning²,

Li³

et al. 2022

BMC Musculoskelet Disord

Self Cite

View full text Add to dashboard Cite

show abstract

“…The AI consists of a questionnaire with ve items that estimate the foot appearance's impact regarding the daily activities at public places, leisure, sexual life, work or school, and personal relationships, with four responses scored from 0 to 3, where 0 is the best score attainable. [12] The complications were recorded during the follow-up.…”

Section: Methodsmentioning

confidence: 99%

Plantar and Dorsal Approaches for Excision of Morton’s Neuroma: A Comparison Study

Ning

et al. 2022

Preprint

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Background: Morton’s neuroma is a painful enlargement of the plantar digital nerve between the metatarsal heads which cause pain of the forefoot. Several approaches have been used to treat the Morton’s neuroma, with each having distinct advantages and disadvantages.Objectives: The purpose of this study was to investigate and compare the clinical outcomes of neurectomy for the treatment of Morton’s neuroma through plantar and dorsal approaches.Material and Methods: We retrospectively analyzed 20 patients aged averagely 48.5±13.0 years(range: 19-66years) who underwent excision of a Morton’s neuroma that had been unresponsive to conservative treatment from June 2014 to June 2021. All the neurectomies were performed through either a plantar or dorsal approach. Outcomes were evaluated using visual analog scale (VAS) scores, American Orthopedic Foot and Ankle Society (AOFAS) scores, the Foot and Ankle Ability Measure (FAAM), and complications. We also used appearance index (AI) to assess the influence of foot appearance on quality of life after surgery.Results: 8 patients underwent neurectomy through a dorsal approach, and 12 patients underwent neurectomy through a plantar approach. The average follow-up time was 28.9±12.9 months(range: 15-72months). There were no statistically significant differences between the dorsal and plantar approach groups with respect to postoperative pain measured by VAS scores. The postoperative AOFAS scores and FAAM outcomes showed no significant differences between the groups. The complications reported in the dorsal approach group were significantly fewer than those of plantar group, mainly discomfort wearing shoes. The AI of the plantar group and the dorsal group were significant different.Conclusion: Excision of Morton’s neuroma through a dorsal or plantar approach both obtained satisfactory outcomes. But the foot appearance after surgery through a plantar approach have less influence on quality of life than a dorsal approach. We recommend that surgeons choose the approach they are most familiar with and most confident in performing. And we recommend the plantar approach if the patient have great need for the appearance.Level of Evidence: Level III, retrospective comparative case series.

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Plantar approach for treatment of brachymetatarsia: A novel approach with an aesthetic consideration

Cited by 2 publications

References 17 publications

Plantar and dorsal approaches for excision of morton’s neuroma: a comparison study

Plantar and dorsal approaches for excision of morton’s neuroma: a comparison study

Plantar and Dorsal Approaches for Excision of Morton’s Neuroma: A Comparison Study

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