Morton's Neuroma (Interdigital Neuritis)

모턴씨 신경종(족지간 신경염)

  • Park, Hyun-Woo (Department of Orthopedic Surgery, Dankook University College of Medicine)
  • 박현우 (단국대학교 의과대학 정형외과학교실)
  • Received : 2011.04.30
  • Accepted : 2011.05.11
  • Published : 2011.06.15

Abstract

Morton's neuroma is a common cause of forefoot pain, and is also known to be a entrapment neuropathy rather than a true tumor. Precise physical examination is necessary to differentiate from other diagnoses of similar symptoms. If proper conservative treatment modalities fail for this neuritis, neurectomy of interdigital nerve is generally performed, with the results of up to 80% of patient's satisfaction. However the failure rate of 2% to 35% should be improved by proper diagnosis and careful surgery.

전족부 통증의 주요 원인 중의 하나인 모턴씨 신경종, 즉 족지간 신경염은 진정한 종양이 아니라 신경 포착 증후군의 일종으로 이해되고 있으며, 진단 시 정확한 이학적 검사와 함께 전족부 통증의 원인이 되는 다른 질환과도 감별해야 한다. 치료에 있어서는 적절한 보존적 치료에도 증상 호전이 되지 않는 환자에게 수술적 치료로서 신경절제술이 주로 시행되어 약 80%의 환자가 만족하는 좋은 결과를 보고하고 있으나, 수술 후 만족스럽지 않은 결과를 보이는 2~35%의 환자를 적절히 처치함으로써 족지간 신경염의 치료 결과를 좀 더 만족스럽게 할 수 있을 것이다.

Keywords

References

  1. Shapiro SL. Endoscopic decompression of the intermetatarsal nerve for Morton's neuroma. Foot Ankle Clin. 2004;9:297-304. https://doi.org/10.1016/j.fcl.2003.12.004
  2. Bennett GL, Graham CE, Mauldin DM. Morton's interdigital neuroma: a comprehensive treatment protocol. Foot Ankle Int. 1995;16:760-3. https://doi.org/10.1177/107110079501601204
  3. Kay D, Bennett GL. Morton's neuroma. Foot Ankle Clin. 2003;8:49-59. https://doi.org/10.1016/S1083-7515(03)00004-4
  4. Stamatis ED, Karabalis C. Interdigital neuromas: current state of the art--surgical. Foot Ankle Clin. 2004;9:287-96. https://doi.org/10.1016/S1083-7515(03)00156-6
  5. Kim JY, Choi JH, Park J, Wang J, Lee I. An anatomical study of Morton's interdigital neuroma: the relationship between the occurring site and the deep transverse metatarsal ligament (DTML). Foot Ankle Int. 2007;28:1007-10. https://doi.org/10.3113/FAI.2007.1007
  6. Levitsky KA, Alman BA, Jevsevar DS, Morehead J. Digital nerves of the foot: anatomic variations and implications regarding the pathogenesis of interdigital neuroma. Foot Ankle. 1993;14:208-14. https://doi.org/10.1177/107110079301400406
  7. Cloke DJ, Greiss ME. The digital nerve stretch test: A sensative indicator of Morton's neuroma and neuritis. Foot and Ankle Surgery. 2006;12:201-3. https://doi.org/10.1016/j.fas.2006.04.002
  8. 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;85:999-1005. https://doi.org/10.1302/0301-620X.85B7.12633
  9. Zanetti M, Strehle JK, Kundert HP, Zollinger H, Hodler J. Morton neuroma: effect of MR imaging findings on diagnostic thinking and therapeutic decisions. Radiology. 1999;213:583-8. https://doi.org/10.1148/radiology.213.2.r99nv06583
  10. Zanetti M, Strehle JK, Zollinger H, Hodler J. Morton neuroma and fluid in the intermetatarsal bursae on MR images of 70 asymptomatic volunteers. Radiology. 1997;203: 516-20. https://doi.org/10.1148/radiology.203.2.9114115
  11. Gauthier G. Thomas Morton's disease: a nerve entrapment syndrome. A new surgical technique. Clin Orthop Relat Res. 1979;(142):90-2.
  12. Park HW. A clinical result of treatment of interdigital neuroma with decompression (4 cases report). J Korean Foot Ankle Soc. 2008;12:106-10.
  13. Barrett SL, Pignetti TT. Endoscopic decompression for intermetatarsal nerve entrapment--the EDIN technique: preliminary study with cadaveric specimens; early clinical results. J Foot Ankle Surg. 1994;33:503-8.
  14. Colgrove RC, Huang EY, Barth AH, Greene MA. Interdigital neuroma: intermuscular neuroma transposition compared with resection. Foot Ankle Int. 2000;21:206-11. https://doi.org/10.1177/107110070002100304