Interdigital (Morton's) Neuroma - Foot & Ankle - Orthobullets
Interdigital (Morton's) Neuroma - Foot & Ankle - Orthobullets
Interdigital (Morton's) Neuroma - Foot & Ankle - Orthobullets
(Morton's) Neuroma Foot & Ankle Orthobullets.com
Search Emiel Abd AlMasseih (Dashboard) Logout
Home QBank Cases Videos Posts Evidence Groups Colleagues Messages Feedback
Trauma Spine Sports Pediatrics Recon Hand Foot&Ankle Pathology Basic Science Anatomy Approaches
Tarsal Navicular FX
Tendon Injuries
Achilles Tendon Rupture
Interdigital (Morton's) Neuroma
0
Author: Evan Watts Topic updated on 03/11/16 3:25pm
Peroneal Tendon Subluxation &
Dislocation Introduction
Anterior Tibialis Tendon
Rupture Compressive neuropathy of the interdigital nerve
Epidemiology
Infection
demographics
Puncture Wound Infections middleaged females (9:1)
body location
Degenerative Conditions most commonly involves the 2nd and 3rd
interdigital nerve between the metatarsal heads
Tendon Conditions Pathophysiology
Posterior Tibial Tendon mechanism of injury
Insufficiency (PTTI) not fully understood
Achilles Tendonitis compression/tension of the interdigital nerve
around the transverse intermetatarsal ligament
FHL Tendonitis & Injuries
repetitive microtrauma
Plantar Fasciitis pathoanatomy
Hallux Disorders perineural fibrosis and entrapment of the interdigital nerve
Hallux Valgus
Anatomy
DJD & Hallux Rigidus
Sesamoid Injuries of the Hallux Interdigital nerve
Turf Toe location
lies plantar to the transverse intermetatarsal ligament between the metatarsal heads
Hallux Varus
components
Lesser Toe Deformities confluence branches of the lateral and medial plantar nerves
Claw Toe
Hammer Toe Presentation
Mallet Toe
Symptoms
Synovitis of 2nd MTP pain
MTP Dislocations worse with weightbearing or wearing narrow toe box shoes (e.g. high heels)
Bunionette Deformity
relief of symptoms by removing shoes and massaging foot
paresthesia
Freiberg's Disease most commonly on the plantar aspect of web space
Arthritic Conditions Physical exam
Osteochondral Lesions of the palpation
Talus neuroma may be palpable
Ankle Arthritis positive webspace compression test
provocative tests
Tibiotalar Impingement
Mulder's click
Midfoot Arthritis bursal click may be elicited by squeezing metatarsals together
Drawer test at metatarsal phalangeal joint (MTPJ)
Neurologic Conditions
assess for MTPJ instability
Diabetic Conditions Imaging
Diabetic Foot Ulcers
Radiographs
Diabetic Foot Charcot
Neuropathy recommended views
weight bearing AP/lateral/oblique views
Neurologic Conditions
findings
Acquired Spastic Equinovarus usually normal
Deformity
may see bony deformity
Interdigital (Morton's) Neuroma Ultrasound
Tarsal Tunnel Syndrome indication
nonpalpable neuroma with clear clinical presentation
Deep Peroneal Nerve
Entrapment findings
oval, hypoechoic mass oriented parallel to the metatarsal bones
Leg Nerve Entrapment
Syndromes outcomes
highly operator dependent
Poliomyelitis
MRI
indication
Procedures not usually required for diagnosis
may be used to rule out other pathologies
Tested Procedure Review
Ankle Arthroscopy Studies
Ankle Arthrodesis
Common digital nerve block
Total Ankle Arthroplasty
indication
confirmatory for accurate diagnosis of interdigital neuroma
http://www.orthobullets.com/footandankle/7041/interdigitalmortonsneuroma 1/3
9/24/2016 Interdigital (Morton's) Neuroma Foot & Ankle Orthobullets.com
confirmatory for accurate diagnosis of interdigital neuroma
findings
Search Emiel Abd AlMasseih (Dashboard)
numbness over lateral surface of toe with relief of patient reported pain Logout
Differential diagnosis
Home QBank Cases Videos Posts Evidence Groups Colleagues Messages Feedback
Procedures
Tested Procedure Review
Ankle Arthroscopy
Please Rate Educational Value! Average 4.0 of 12 Ratings
Ankle Arthrodesis
Total Ankle Arthroplasty
Qbank (0 Questions)
http://www.orthobullets.com/footandankle/7041/interdigitalmortonsneuroma 2/3
9/24/2016 Interdigital (Morton's) Neuroma Foot & Ankle Orthobullets.com
Search Emiel Abd AlMasseih (Dashboard) Logout
Home QBank Cases Videos Posts Evidence Groups Colleagues Messages Feedback
Groups
Trauma Spine Sports Pediatrics Recon Hand Foot&Ankle Pathology Basic Science Anatomy Approaches
Tarsal Navicular FX
Oral Boards: Interdigital (Morton's) Neuroma 7/29/2011
Tendon Injuries General Oral Boards Review 0 responses
Achilles Tendon Rupture
Peroneal Tendon Subluxation &
Dislocation Topic Comments Subscribe status: On Off
Anterior Tibialis Tendon
Rupture
Infection
Puncture Wound Infections
Insert Pubmed Reference
Degenerative Conditions
Comment as: Emiel Abd AlMasseih Add Comment
Tendon Conditions
Posterior Tibial Tendon Hide Comments (10)
Insufficiency (PTTI)
Achilles Tendonitis Ashraf mohamad commented at 12:12PM on 06/11/15
FHL Tendonitis & Injuries Im like to share this case of boy 14 years with lt. Sided calcanoevalgus with flat foot ans
abduction of forefoot, i reqcuest triple xray foot and c.t. And m.r.i.
Plantar Fasciitis
Simply before showing pictures ,
Hallux Disorders When we can to manage foot deformities ?
Hallux Valgus Simple osteotomies of complex foot deformities?
DJD & Hallux Rigidus
KASHIF SYED commented at 1:25PM on 05/02/15
Sesamoid Injuries of the Hallux
body location
Turf Toe most commonly involves the 2nd and 3rd interdigital nerve between the metatarsal heads
Hallux Varus
confluence branches of the lateral and medial plantar nerve
Lesser Toe Deformities
Claw Toe isnt this confluence isbetween 3rd and 4th toes, even in Miller it is written 3rd and 4th toe , what
Hammer Toe is the correct site.thanks
Mallet Toe
Anonymous commented at 12:31PM on 12/30/14
Synovitis of 2nd MTP
how effective are steroid injections?
MTP Dislocations
Bunionette Deformity Jay stanley commented at 4:16PM on 05/07/12
Freiberg's Disease Under treatment it lists "find out about IMTL". From doing SAE's it appears this should be
Arthritic Conditions released. additionally on revision cases recommendation is to go plantar.
Osteochondral Lesions of the
Talus Anonymous commented at 5:27PM on 04/15/12
Ankle Arthritis
High failure rates occur with neuroma resections which do not involve the 3rd web space and
most likely represent a misdiagnosis.
Tibiotalar Impingement
Midfoot Arthritis Anonymous commented at 5:21PM on 04/15/12
Merve to merge correction noted in the comments, but in the same sentence perineum remains
Neurologic Conditions uncorrected.
Diabetic Conditions Patrick McCulloch commented at 8:13PM on 04/18/11
Diabetic Foot Ulcers Thanks for your edits, Dr. Sanders.
Diabetic Foot Charcot
Neuropathy Pete Sanders commented at 7:46PM on 04/18/11
Neurologic Conditions Typos(corrections in parentheses):
Acquired Spastic Equinovarus unique anatomy in that medial branch of LPN and lateral branch of MPN merve(merge) and
Deformity share a common perineum
Interdigital (Morton's) Neuroma
pain relieved be(by) removing shoe and messaging(massaging) foot
Tarsal Tunnel Syndrome
Deep Peroneal Nerve also probably worth noting the Mulder's Sign in the physical exam:
Entrapment Mulder, JD. "The causative mechanism in morton's metatarsalgia." J Bone Joint Surg.
Leg Nerve Entrapment 1951;33B:9495.
Syndromes
Poliomyelitis Derek Moore commented at 1:07PM on 03/11/11
Ismail, thanks for bringing that to our attention. We fixed those errors. Remember, under your
Profile & Settings, can can customize your email notifications. Thanks again for your feedback!
Procedures
Tested Procedure Review Ismail MOEMEN ABDELAAL commented at 7:27AM on 03/10/11
Ankle Arthroscopy image and question links not working
Ismail MOEMEN ABDELAAL
Ankle Arthrodesis
Total Ankle Arthroplasty
http://www.orthobullets.com/footandankle/7041/interdigitalmortonsneuroma 3/3