• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.80-83
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• 2006

Purpose: To compare ultrasonographic size of morton's neuroma measured to actual size. Materials and Methods: Thirty-two (twenty-eight patients) of symptomic Morton's neuroma were measured by ultrasonography preoperatively and by manual method that designed by authors intraoperatively from January, 2002 to May, 2003. Two results were stastically compared by paired T-test. Results: Except one, all of cases were women and the mean age of patients was 50.6 years (32-62 years). The most common associated disease was hallux valgus deformity (17 cases). Six of Morton's neuromas located on second intermetatarsal space, sixteen of them did third intemetatarsal space and ten of neuromas located simultaneously second and third intermetatarsal space. The ultrasonographic size of neuroma averaged 3.48 mm and real size was 3.99 mm. The size checked by manual method was larger than by ultrasound with statical meaning. Conclusion: The size of Morton's interdigital neuroma checked by ultrasonography on plantar aspect is smaller than real size. If you checked Morton's interdigital neuroma size by ultrasonography, you can suspect that real size of Morton's interdigital neuroma is larger than that size.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.31-36
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• 2006

Purpose: To evaluate the usefulness of ultrasound and MRI in diagnosing Morton's Neuroma, and the effect and significance of stepwise treatment. Materials and Methods: Out of all patients suspected of Morton's neuroma through history taking and physical examination, 77 patients (84 feet, 95 lesions) in whom Morton's neuroma was confirmed by ultrasound or MR imaging study or was clinically suspected with negative imaging studies, and followed up for over 3 months were included. In all cases, history taking and imaging study were done, and by comparison with operative findings of the patients, the sensitivity of ultrasound and MRI was checked. Postoperative evaluation was done using the AOFAS scale. The patient's satisfaction was also examined. Results: Morton's neuroma occurred most frequently at the $3^{rd}$ web space of the foot (56%), followed by the $2^{nd}$ web space (44%). Out of 15 cases suspected of morton's neuroma through ultrasound study, 13 were pathologically positive showing a sensitivity of 85.7%. Out of 16 cases suspected of morton's neuroma through MRI, 14 were pathologically positive showing a sensitivity of 83.3%. There was no significant difference in sensitivity between the two imaging modalities. Conclusion: In diagnosing Morton's neuroma, ultrasound examination had a similar sensitivity with MRI, therefore can be used as a screening study.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.106-110
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• 2008

Morton's neuroma has been treated with resection of the enlarged interdigital nerve by most of surgeons, but the numbness after resection could bother the patients. We reported the experiences of the good results after treatment of Morton's neuroma with the decompression of the interdigital nerve. Three patients, 4 feet were diagnosed to Morton's neuroma and taken the surgery, decompression of the interdigital nerve after the conservative treatments. The decompression can be considered first as another choice of treatment for interdigital neuroma before resection of the nerve.

• Journal of Korean Foot and Ankle Society
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• v.19 no.2
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• pp.58-62
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• 2015

Purpose: The purpose of this report is to investigate the clinical and radiological results of corrective osteotomy of the 3rd metatarsal bone for shortening and dorsal displacement without exposure around neuroma. Materials and Methods: Twelve cases of patients who underwent corrective osteotomy of metatarsal bone for a Morton's neuroma from November 2013 to September 2014 were retrospectively reviewed. Corrective osteotomy was performed through a dorsal approach at the 3rd metatarsal bone base and distal metatarsal bone was displaced dorsally and proximally. Preoperative and postoperative pain assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and radiographs were evaluated. Results: The mean age of patients was 41.4 years, and the mean follow-up period was 10.7 months. AOFAS score improved from 52 preoperatively to 90 postoperatively. The 3rd metatarsal bone was shortened by an average of 3.39 mm and elevated by 2.38 mm. Conclusion: Corrective osteotomy of metatarsal bone can be regarded as a new surgical option for Morton's neuroma without exposure around neuroma.

• Journal of Korean Foot and Ankle Society
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• v.15 no.2
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• pp.58-61
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• 2011

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.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.131-134
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• 2005

Purpose: The purpose of this study was to investigate the clinical results of conservative treatment for Morton's neuroma and to analyze the factors which influenced on the results. Materials and Methods: In this retrospective study, 101 cases of 83 patients with interdigital neuroma were conservatively treated with follow-up period of at least 6 months. There was no significant difference in results among different age groups, sxes, and lesion sites. However, the results were significantly better if the treatment was started within 6 months after onset. Results: We had 28 excellent results (28%), and 13 good results (13%). Patients were grouped by sex, age, duration of symptom before treatment, affected location. The result of treatment was evaluated by comparing the subject pain and discomfort score of the first vist and last follow-up. Conclusion: There are excellent results over 41% by conservative treatment. The results of conservative treatment were not related to age, sex, and lesion site, but were related to pre-treatment period. The shorter the pretreatment period was, the better the results.

• Journal of Korean Foot and Ankle Society
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• v.7 no.1
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• pp.131-134
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• 2003

Most interdigital neuroma can be diagnosed clinically. But, diagnostic local injection method, sonography and magnetic resonance image(MRI) have been used as secondary tests for clinical confirmation or surgery. Recently, there have been active discussions on the method of interdigital neuroma diagnosis for which sonography or MRI is used. For finding out the location or the number of interdigital neuroma particularly in non-typical clinical manifestation or surgery, MRIs, which are exellent in tissue contrast, may be quite helpful. This case had an interdigital neuroma showing non-typical manifestation. MRIs were used for clinical diagnostic confirmation and finding out the location and the number of interdigital neuroma. Thus, the validity along with literary consideration is being reported.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.2
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• pp.61-65
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• 2012

Purpose: The aim of this study was to evaluate the effectiveness of ultrasound-guide steroid injection according to Morton's neuroma size. Materials and Methods: From October 2008 to September 2011, 17 patients (23 cases) diagnosed with Morton's neuroma were investigated. All cases were female and mean age was 52.6 years old. Neuroma were measured by the horizontal and longitudinal length of the mass and underwent ultrasound-guided steroid (5 mg dexamethasone) injection. The efficacy of the injection was determined by Visual Analogue Scale pain score and patient satisfaction(subdivided 4 group-much improved, improved, not improved, aggrevation) Results: 7 of 23(30.4%) cases showed much improved and improved satisfaction and mean longitudinal and horizontal length were $0.71{\pm}0.39cm$ and $0.47{\pm}0.24cm$, respectively. 16 of 23(69.6%) cases showed not improved and aggrevation satisfaction and mean longitudinal and horizontal length were $0.83{\pm}0.42cm$ and $0.54{\pm}0.14cm$, repectively. There was a significant difference in VAS and patient satisfaction in case longitudinal and horizontal length were smaller than 0.5 cm and 0.4 cm. (p<0.05) Conclusion: The ultrasonography is a important modality in diagnosis and treatment of morton's neuroma. Ultrasound-guide steroid injection is effective in case longitudinal and horizontal length were smaller than 0.5 cm and 0.4 cm, respectively.

• Journal of Korean Foot and Ankle Society
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• v.17 no.3
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• pp.203-208
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• 2013

Purpose: We analyzed retrospectively the effect of pyridoxine in the treatment of peripheral nerve related foot pain because we have seen favorable clinical results from it as a monotherapy. Materials and Methods: We analyzed the clinical results of 200 cases of peripheral nerve related foot pain, treated with pyridoxine from March 2009 to February 2012. We devided them into three groups, peripheral neuritis, Morton's neuroma and posttraumatic neuralgia and recorded percentage of improvement of pain, compared to initial pain level at 2 weeks and 6 weeks. Results: There were 127 peripheral neuritis cases, 22 Morton's neuroma and 51 posttraumatic neuralgia. At 2 weeks after treatment, 135 cases(67.5%) showed pain relief. At 6 weeks, 36 cases(21%) showed complete improvement of pain, 81 cases(47%) showed more than 50 % of improvement, 22 cases(13%) showed less than 50% of improvement and 33 cases(19%) showed no improvement. There are 4 cases of gastrointestinal discomfort and 2 cases of aggravation of nervy pain. Conclusion: Pyridoxine was effective drug in the treatment of peripheral neuropathic pain in terms of pain relief, safety and cost effectiveness. So it can be an available first line drug before adding other drugs.

• Journal of Yeungnam Medical Science
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• v.36 no.2
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• pp.92-98
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• 2019

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.