Operative treatment of interdigital neuroma - A long term follow-up study

Citation
Mj. Coughlin et T. Pinsonneault, Operative treatment of interdigital neuroma - A long term follow-up study, J BONE-AM V, 83A(9), 2001, pp. 1321-1328
Citations number
57
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
Journal title
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
ISSN journal
0021-9355 → ACNP
Volume
83A
Issue
9
Year of publication
2001
Pages
1321 - 1328
Database
ISI
SICI code
0021-9355(200109)83A:9<1321:OTOIN->2.0.ZU;2-1
Abstract
Background: The literature regarding the outcome of surgical treatment of i nterdigital neuroma is incomplete. The purpose of this study was to assess the demographics associated with the presentation of an interdigital neurom a as well as the long-term clinical results of operative resection by a sin gle surgeon. Methods: A retrospective review of the patient records of one orthopaedic f oot and ankle surgeon identified eighty-two patients who had been treated o peratively for a primary, persistently painful interdigital neuroma more th an three years previously. Of these eighty-two patients, sixty-six (seventy -one feet, seventy-four neuromas) returned at an average of 5.8 years for a follow-up evaluation, which included a review of the interval history sinc e the surgery, a physical examination, a radiographic evaluation, and an as sessment of the patient's satisfaction with the result of the surgery. Results: Overall satisfaction was rated as excellent or good by fifty-six ( 85%) of the sixty-six patients. Forty-six (65%) of the seventy-one feet wer e pain-free at the time of final follow-up. The patients who had had either bilateral neuroma excision or excisions of adjacent neuromas in the same f oot in a staged fashion had a slightly lower level of satisfaction, but thi s difference was not significant. While major activity restrictions followi ng surgery were uncommon, mild or major shoe-wear restrictions were noted b y forty-six of the sixty-six patients. Although there was subjective numbne ss in thirty-six of the seventy-one feet, the pattern of numbness was quite variable and it was bothersome in only four feet. Conclusion: With careful preoperative evaluation and patient selection, res ection of a symptomatic interdigital neuroma through a dorsal approach can result in a high percentage of successful results more than five years foll owing the procedure.