Abordaje comisural mini-invasivo del neuroma de morton evolución a largo plazo

Abstract

The interdigital neuroma is a frequent cause of metatarsalgia. Given the failure of conservatlve treatment, the classical treatment, surgery with neuroma's resection, is performed. The objective of this study is to present the technique and the results obtained from interdigital neuroma surgery by commissural approach, its long-term results, its compllcations and sequelae. Material and method: We have retrospectively analyzed 105 neuromas, operated via commissural, 98 women and 7 men. 81 neuromas were presented single. ln 4 cases, there were two neuromas in different spaces, but same foot; and 8 patients showed bilateral neuroma. The average age was 54 years (31-72). In all cases, we started with conservative treatment. The surgery was defined at least 3 months later with the failure of the conservative treatment. ln all patients minimally invasive commissural approach was implemented. Mean follow-up was 76 months. Results: 93 cases had resol ution of their clinical symptoms and resumed their activities within two months postoperatively. 9 cases showed transient improve ment. 3 patients had poor outcome. ln the postoperative, the patients reported no pain after a week of surgery and in all cases were satlsfied by the scar cosmesis. Two patients had wound dehiscence. There were no hypertrophic scars. 3 cases showed discomfort in the scar's plantar angle. There were no complications in tendon, vascular-nerve, or difficulties with footwear. Conclusions: The commissural approach allows a cosmeticscar not shrinked and painless. lt does not damage either the ligament or fascial planes. lt allows the extension of itself if necessary. lt can be done with local anesthesia, and drainage is not necessary. Traction is required for the full resection of the neuroma. lt presents satisfactory clinical results.