Abstract
Morton’s Metatarsalgia is a painful condition and can often be debilitating. The value of surgical exicion has been doubted due to low success rate of surgical intervention.
Objective: The purpose of this study is to examine the variation in the management steps of Morton’s Metatarsalgia.
Methods: Several Surgeons from different European countries answered a questionnaire in regard to their routine management of a typical Morton’s Neuroma patient.
Results: 25 surgeons (100%) stated they would routinely elicit intermetatarsal tenderness in comparison to 14(56%) and 10 (40%) surgeons who would routinely elicit Intermetatrsal tenderness and Mulder’s click respectively. The majority of them (84%) will routinely request plain foot radiograph, while 7 surgeons(28%) uses ultrasound routinely. Coservative management is initiated by 16 surgeons(64%). Local injection was first line of treatment among 13 surgeons (56%). Surgical treatment is favoured by 10 surgeons(40%), while only one surgeon (4 %) would use ultrasound guided injection routinely. The popular surgical approach is dorsal incision (75%). If surgical option was chosen then neurectomy is attempted by 17 (68%) surgeons.
Conclusion: Considerable variation exists among continental surgeons in their initial management of a typical Morton’s Neuroma patient. This is probably due to lack of understanding of the true aetiology of the Morton’s “Neuroma”.
Correspondence should be addressed to the Honorary Secretary, BOFSS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
