Is endoscopic decompression for Morton's neuroma a safe technique?

Q3 Medicine Revista Espanola de Cirugia Ortopedica y Traumatologia Pub Date : 2024-10-10 DOI:10.1016/j.recot.2024.10.005

L López-Capdevila, M Ballester, G Lucar, T Mota-Gomes, M Fa-Binefa, S López-Hervás

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Abstract

Introduction: Morton's neuroma is predominantly attributed to chronic nerve entrapment within third space adjacent metatarsals, the deep transverse metatarsal ligament (DTML), and the plantar skin. While conservative treatments are of election, failures require alternative interventions such as ultrasound-guided injections and various surgical procedures, including minimally invasive neurectomy and DTML release. This study aimed to anatomically assess the risks associated with the endoscopic dorsal surgical decompression of Morton's neuroma.

Materials and methods: Twenty feet from ten fresh-frozen cadaveric specimens underwent a dorsal percutaneous approach for endoscopic access. Surgical procedures were monitored by three foot and ankle surgeons. Post-surgical anatomical dissections were conducted to evaluate potential risks to surrounding structures.

Results: The endoscopic technique successfully sectioned the DMTL in all specimens (100%) without iatrogenic injury of tendons, nerves, or arteries, while lumbricals may be at risk.

Conclusion: Endoscopic dorsal decompression of Morton's neuroma presents as an accessible minimally invasive surgical option with low risk of collateral associated injuries.

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内窥镜减压治疗莫顿神经瘤是一种安全的技术吗？

简介：莫顿神经瘤主要是由于相邻跖骨第三间隙、跖深横韧带（DTML）和足底皮肤内的慢性神经卡压所致。虽然保守治疗是可行的，但如果治疗失败，则需要采取其他干预措施，如超声引导注射和各种外科手术，包括微创神经切除术和 DTML 松解术。本研究旨在从解剖学角度评估莫顿神经瘤内窥镜背侧手术减压的相关风险：来自十具新鲜冷冻尸体标本的二十只脚接受了背侧经皮入路内窥镜手术。手术过程由三位足踝外科医生监控。手术后进行解剖解剖，以评估对周围结构的潜在风险：结果：内窥镜技术在所有标本（100%）中都成功切开了DMTL，没有对肌腱、神经或动脉造成先天性损伤，但韧带可能存在风险：结论：内窥镜背侧减压术治疗莫顿神经瘤是一种方便易行的微创手术选择，侧支相关损伤的风险较低。

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来源期刊

Revista Espanola de Cirugia Ortopedica y Traumatologia Medicine-Surgery

CiteScore

1.10

自引率

0.00%

发文量

156

审稿时长

51 weeks

期刊介绍： Es una magnífica revista para acceder a los mejores artículos de investigación en la especialidad y los casos clínicos de mayor interés. Además, es la Publicación Oficial de la Sociedad, y está incluida en prestigiosos índices de referencia en medicina.