O3087 TREATMENT OF RECURRENCE AFTER EXCISION OF AN INTERDIGITAL NEUROMA, UTILIZING A DORSAL APPROACH-A RETROSPECTIVE REVIEW

Abstract

Aims: To evaluate the outcome of our consecutive series of patients who underwent revision surgery due to unresolved or recurrent symptoms after an initial procedure or procedures for interdigital neuroma excision. Methods: In a six year period 49 patients underwent revision neuroma surgery utilizing a dorsal approach. Sixty interspaces were re-explored. In addition, ten patients underwent primary neuroma resection from an adjacent interspace, while 19 patients underwent concomitant forefoot surgery. Results: The average duration of postoperative follow-up was 39.7 months. Fifteen patients (30.7%) were completely satis-þed, thirteen (26.5%) satisþed with minor reservations, ten (20.4%) satisþed with major reservations and eleven (22.4%) dissatisþed with the postoperative outcome. The exploration of two adjacent interspaces, the intraopera-tive þndings, the concomitant forefoot surgery and the previous attempts at re-exploration had an inßuence on the þnal outcome. Seven patients (14.3%) had no footwear restrictions, thirteen patients (26.5%) had mild, twenty-one (42.9%) had moderate and eight (16.3%) severe footwear restrictions. Nineteen patients (38.8%) had no activity restrictions, twenty-two (44.9%) had mild, eight (16.3%) moderate and none reported severe restrictions interfering with daily activities. Conclusions: Persistent or recurrent symptoms after nerve transection present a challenging problem for both the surgeon and the patient. Thorough preoperative discussion must be undertaken with the patient, providing the average rates of failure and the increased likelihood of footwear and activity restrictions.