This disease, first described by TG Morton in 1876, originates from the nerve between the 3rd and 4th metatarsal bones of the foot. It can occur as a result of compression of these nerves, which are responsible for the sensation of the fingers on the sole of the foot, mostly due to the foot structure. It is seen between the ages of 40-60 and 8 times more in women than men. It is often seen between 2-3 or 3-4 comb bones. Although it is associated with high heels or tight shoes, it can be relieved by removing the shoes and massage.
What are the Symptoms of Morton Neuroma?
The exact cause of Morton's neuroma is unknown. It is suggested that shoes that narrow by pointing forward, and repetitive jumping movements on a hard floor affect the nerve and cause it to thicken. The transverse metatarsal ligaments connecting the metatarsal bones to each other are located like a roof over the nerve in the foot, causing the thickened nerve to remain in a narrow area and compressed when pressed everywhere. Patients can express that they feel like they are walking on marble. The pain may radiate to the 3rd and 4th fingers and may be relieved by removing shoes. Situations such as swelling are not frequently encountered.
How can the diagnosis be made?
Complaints may increase by manually squeezing between the comb bones. Your doctor may want you to have imaging methods such as X-ray, ultrasound or MRI for diagnosis. X-ray is of limited use in diagnosing Morton's neuroma, but it is helpful in differentiating other diseases. This lesion can be seen in contrast-enhanced MRIs taken especially in cases of doubt. By cutting the transverse ligament with a cm incision, the nerve is released or the thickened nerve segment is removed. Non-surgical treatment can reduce complaints only in 15-20% of patients. The aim here is to reduce the pressure on the nerve.
Complaints are tried to be reduced by restricting the movement of the fingers with wide-topped shoes, shoes without heels or tight-hard insoles. Administering steroids to the lesion and taking oral pain relievers It can provide relief as a flower. Insoles, pads, and orthoses have not been shown to provide significant benefit.
What kind of a surgical approach is applied?
This lesion can be removed with an incision made on the sole of the foot or on the back of the foot. The choice of these techniques may vary depending on the surgeon's choice and the location of the mass.
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