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CC BY-NC-ND 4.0 · Joints 2019; 07(03): 127-130
DOI: 10.1055/s-0040-1712112
Case Report

Five Centimeters Morton's Neuroma in a 46-Year-Old Woman Affected by Macrodactily

Francesco Di Caprio
1   Operating Unit of Orthopedics and Traumatology, Istituto per la Sicurezza Sociale di San Marino, San Marino, Italy
,
Renato Meringolo
2   AUSL of Romagna, Operating Unit of Orthopedics and Traumatology, Ceccarini Hospital, Riccione, Italy
,
Maria Adiletta Navarra
2   AUSL of Romagna, Operating Unit of Orthopedics and Traumatology, Ceccarini Hospital, Riccione, Italy
,
Massimiliano Mosca
3   First Orthopedics and Traumatology Clinic, Rizzoli Orthopedic Institute, Bologna, Italy
,
Lorenzo Ponziani
1   Operating Unit of Orthopedics and Traumatology, Istituto per la Sicurezza Sociale di San Marino, San Marino, Italy
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Abstract

The present article described the case of a voluminous Morton's neuroma of the third intermetatarsal space in a patient affected by macrodactily. The case was unique because of its dimensions, the uncommon surgical approach which was needed for removal, the association with macrodactily of the fourth toe with Raynaud's phenomenon, and the postoperative defect in the intrinsic muscles. The patient was operated in February 2016 by transverse plantar approach. Twelve months after surgery, the patient complained for hypoesthesia on third and fourth toes with inability to actively spread the toes and enlargement in the second interdigital space. The dimensions of the lesions may be explained with the presence of macrodactily in the fourth toe with occasional Raynaud's phenomenon, which may have caused an abnormal arrangement of the nerve branches for the fourth interspace with related microtrauma. A plantar approach was highly recommended as the size of the lesion forced it to the plantar surface of the foot. The inability to actively spread the toes and the enlargement of the second interdigital space are likely to be related to a deficiency of the interosseous muscles, innervated by the deep branch of the lateral plantar nerve, which had probably been sacrificed because of the size of the lesion and the subversion of the surrounding anatomical relationships.

Keywords

Morton - foot - neuroma - macrodactily - Raynaud


Publikationsverlauf

Eingereicht: 15. September 2017

Angenommen: 13. April 2020

Artikel online veröffentlicht:
20. Mai 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Di Caprio F, Meringolo R, Shehab Eddine M, Ponziani L. Morton's interdigital neuroma of the foot: a literature review. Foot Ankle Surg 2018; 24 (02) 92-98
    CrossrefPubMedGoogle Scholar
  • 2 Jones JR, Klenerman L. A study of the communicating branch between the medial and lateral plantar nerves. Foot Ankle 1984; 4 (06) 313-315
    CrossrefPubMedGoogle Scholar
  • 3 Diez EM, Mas SM, Pi JF, Aramburo F. Comparative results of two different techniques in the treatment of the Morton's neuroma. Foot 1999; 9 (03) 134-137
    CrossrefPubMedGoogle Scholar
  • 4 Bennett GL, Graham CE, Mauldin DM. Morton's interdigital neuroma: a comprehensive treatment protocol. Foot Ankle Int 1995; 16 (12) 760-763
    CrossrefPubMedGoogle Scholar
  • 5 Alexander IJ, Johnson KA, Parr JW. Morton's neuroma: a review of recent concepts. Orthopedics 1987; 10 (01) 103-106
    CrossrefPubMedGoogle Scholar
  • 6 Faraj AA, Hosur A. The outcome after using two different approaches for excision of Morton's neuroma. Chin Med J (Engl) 2010; 123 (16) 2195-2198
    PubMedGoogle Scholar
  • 7 Quinn TJ, Jacobson JA, Craig JG, van Holsbeeck MT. Sonography of Morton's neuromas. AJR Am J Roentgenol 2000; 174 (06) 1723-1728
    CrossrefPubMedGoogle Scholar
  • 8 Kundert HP, Plaass C, Stukenborg-Colsman C, Waizy H. Excision of Morton's neuroma using a longitudinal plantar approach: a midterm follow-up study. Foot Ankle Spec 2016; 9 (01) 37-42
    CrossrefPubMedGoogle Scholar
  • 9 Richardson DR, Dean EM. The recurrent Morton neuroma: what now?. Foot Ankle Clin 2014; 19 (03) 437-449
    CrossrefPubMedGoogle Scholar
  • 10 Nery C, Raduan F, Del Buono A, Asaumi ID, Maffulli N. Plantar approach for excision of a Morton neuroma: a long-term follow-up study. J Bone Joint Surg Am 2012; 94 (07) 654-658
    CrossrefPubMedGoogle Scholar
  • 11 Glasoe WM, Coughlin MJ. A critical analysis of Dudley Morton's concept of disordered foot function. J Foot Ankle Surg 2006; 45 (03) 147-155
    CrossrefPubMedGoogle Scholar
  • 12 Makki D, Haddad BZ, Mahmood Z, Shahid MS, Pathak S, Garnham I. Efficacy of corticosteroid injection versus size of plantar interdigital neuroma. Foot Ankle Int 2012; 33 (09) 722-726
    CrossrefPubMedGoogle Scholar
  • 13 Mahadevan D, Venkatesan M, Bhatt R, Bhatia M. Diagnostic accuracy of clinical tests for Morton's neuroma compared with ultrasonography. J Foot Ankle Surg 2015; 54 (04) 549-553
    CrossrefPubMedGoogle Scholar
  • 14 Sharp RJ, Wade CM, Hennessy MS, Saxby TS. The role of MRI and ultrasound imaging in Morton's neuroma and the effect of size of lesion on symptoms. J Bone Joint Surg Br 2003; 85 (07) 999-1005
    CrossrefPubMedGoogle Scholar