The plantar approach for management of a Morton neuroma allows the transverse metatarsal ligament to be spared, decreases the risk of damage to the dorsal cutaneous nerve branches, and has a low rate of complications with results comparable with those of other approaches.
Step 1: Incision
Make a transverse plantar skin incision distal to the metatarsal weight-bearing area.
Step 2: Exposure
Excise the connective tissues around the neuroma and expose the common digital nerve as far proximally as possible.
Step 3: Resection
Identify the resection point over the metatarsal neck and cut the neural branches as proximal and as distal as possible.
Step 4: Closure
Suture the fat pad using inverting absorbable sutures and the skin using nonabsorbable monofilament sutures.
We assessed 160 of 168 patients who had undergone surgical excision of a Morton neuroma; the median duration of follow-up was 7.1 years13.
What to Watch For
Pitfalls & Challenges