Plantar Approach for a Morton Neuroma: Surgical Technique.

Introduction: 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.

Results: We assessed 160 of 168 patients who had undergone surgical excision of a Morton neuroma; the median duration of follow-up was 7.1 years.

What To Watch For: IndicationsContraindicationsPitfalls & Challenges.