J Korean Foot Ankle Soc.  2015 Jun;19(2):58-62. 10.14193/jkfas.2015.19.2.58.

Corrective Osteotomy of Metatarsal Bone for Surgical Treatment of Morton's Neuroma

• Chu I
• Jang H
• Park HW

• KMID: 1794884
• DOI: http://doi.org/10.14193/jkfas.2015.19.2.58

Abstract

PURPOSE
The purpose of this report is to investigate the clinical and radiological results of corrective osteotomy of the 3rd metatarsal bone for shortening and dorsal displacement without exposure around neuroma.
MATERIALS AND METHODS
Twelve cases of patients who underwent corrective osteotomy of metatarsal bone for a Morton's neuroma from November 2013 to September 2014 were retrospectively reviewed. Corrective osteotomy was performed through a dorsal approach at the 3rd metatarsal bone base and distal metatarsal bone was displaced dorsally and proximally. Preoperative and postoperative pain assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and radiographs were evaluated.
RESULTS
The mean age of patients was 41.4 years, and the mean follow-up period was 10.7 months. AOFAS score improved from 52 preoperatively to 90 postoperatively. The 3rd metatarsal bone was shortened by an average of 3.39 mm and elevated by 2.38 mm.
CONCLUSION
Corrective osteotomy of metatarsal bone can be regarded as a new surgical option for Morton's neuroma without exposure around neuroma.

Keyword

Metatarsal bones; Osteotomy; American Orthopaedic Foot and Ankle Society score; Neuroma; Metatarsalgia

MeSH Terms

Ankle
Follow-Up Studies
Foot
Humans
Metatarsal Bones*
Metatarsalgia
Neuroma*
Osteotomy*
Pain, Postoperative
Retrospective Studies

Figure

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  Figure 1. Widened web space by metatarsal pad.

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  Figure 2. Method for the measurement of 3rd metatarsal length. Third metatarsal length (dashed line) was determined by measuring the distances from apex of each metatarsal to transmetatarsal line centered from lateral sesamoid and perpendicular to the second metatarsal axis.

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  Figure 3. Metatarsal osteotomy from proximal dorsum to distal base obliquely.

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  Figure 4. Metatarsal osteotomy was stabilized using a screw and proximal dorsal edge was cut off.

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  Figure 5. C-arm radiographs. (A) Preoperative sesamoid view. (B) Postoperative sesamoid view (arrow). Third metatarsal bone was dorsally displaced after the metatarsal corrective osteotomy.

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  Figure 6. (A) Preoperative foot standing anteroposterior (AP) radiograph. (B) Postoperative foot standing AP radiograph. After the metatarsal corrective osteotomy, the length of 3rd metatarsal bone was shortened.

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