Comment se déroule l'opération du névrome de morton ?

Morton's neuroma is known as a painful condition that affects the front of the foot and can be very troublesome. Thus, although Morton's neuroma can be treated with special, adapted footwear to the plantar morphology, it is sometimes also necessary to undergo surgery to relieve the pain caused by this pathology, should natural treatment of the condition fail. 

That's why this article will explain in detail what Morton's neuroma surgery involves, what its causes and symptoms are, and how to treat it.

Morton's neuroma: causes, symptoms and treatment

Morton's neuroma is a painful condition that generally occurs more in the front of the foot, between the third and fourth toesand is caused by compression of an interdigital nerve. In other words, it's caused by excessive friction or pressure on an intermediate nerve that lies just beneath the skin.

However, a flat foot, plantar deformity (hallux valgus), excess weight, the wearing of narrow, unsuitable shoes as well as excessive participation in certain sports can all be risk factors for Morton's neuroma. 

The most common symptoms of this pathology are numbness and acute pain, as well as tingling and pain when pressure is exerted on the affected area. Morton's neuroma causes severe pain in the foot, combined with a loss of sensitivity in the toes. That's why it's advisable to wear shoes for Morton's neuroma if you want to cope with the pain caused by this pathology.

However, there are various treatment options available to alleviate the symptoms of Morton's neuroma, such as the use of orthotics and adapted footwear. In order to avoid more intrusive surgery, laser treatment of Morton's neuroma is also possible. If medical treatment fails, Morton's neuroma surgery may be considered as a last resort.

Morton's neuroma operation

A Morton's neuroma operation is a surgical procedure performed by an orthopedic surgeon to reduce the pressure causing pain by removing the compressed nerve. To achieve this, the operation should follow a series of steps.

Preparing for Morton's neuroma surgery

Before undergoing surgery for Morton's neuroma, it is important for the patient to consult an anaesthetist, who will guide you towards the most suitable solution for your profile. However, Morton's neuroma surgery can be performed using 3 types of anesthesia:

  • Under local anaestheticUnder local anaesthetic, through desensitization of the toe area.
  • Under locoregional anesthesia: The preferred solution for the majority of operations, this type of anesthesia involves desensitization of the leg.
  • Under general anesthesia This type of anesthesia is used for patients who prefer to be unconscious during the operation.

Morton's neuroma operation

Generally, a surgical intervention for Morton's neuroma does not last long, and it also depends on the individual case and the size of the neuroma. There are two main surgical procedures that can be performed to eliminate Morton's neuroma: neurolysis and neurectomy.

  • In the first procedure, i.e. neurolysisMorton's neuroma surgery involves incising the intermetatarsal ligament to remove the compressed nerve and reduce the pressure that causes the intense pain. In most cases, this procedure is performed under local anaesthetic and takes just a few minutes.
  • In the second case, i.e. neurectomy or neurectomy, surgery for Morton's neuroma involves removal of the nerve that causes the pain. Like neurolysis, this type of operation also requires incision of the back of the foot.

Post-operative follow-up and possible complications

Post-operative follow-up for Morton's neuroma

 In order to be able to walk well after Morton's neuroma operation, it is very important to follow your surgeon's instructions and rest as much as possible. In some cases, your surgeon may prescribe medication, the use of a cane or the use of a walking aid. postoperative footwear to relieve pain and reduce inflammation.

Nevrome de morton operation work stoppage

Physiotherapy may also be recommended to help improve mobility and prevent recurrence. However, depending on the type of profession you practice, surgical treatment of Morton's neuroma may :

  • require you to take one to two months off work 
  • Prohibit you from driving for at least 3 weeks.
  • Allow you to resume cycling one month after the operation.
  • You must wait two months or more before practicing other sports.

Complication operation Nevrome de morton

After surgery, the most common sequelae of morton nevroma surgery include infection, insufficient healing and persistent pain. However, other possible complications include:

  • swelling of the foot
  • Loss of sensitivity in the toes near the neuroma, but this resolves over time in most patients.
  • Stiffness of the foot. In most cases, stiffness is accompanied by osteoarthritis of the big toe after surgery for Morton's neuroma, making it disabling.
  • Algodystrophy is also a rare post-operative complication, and can lead to pain on weight-bearing. However, it can be treated with Calcitonin injections.
  • Infection: diabetic patients and smokers run a much higher risk of infection, which may require further surgery to clean out the abscess.

Morton's neuroma operation advice

According to the opinions of several patients who have undergone surgery for Morton's neuroma, the pain after Morton's neuroma surgery persists for a long time. one case in 10 after surgery. Generally speaking, following Morton's neuroma operation, it is commonplace to experience discomfort or pain after treatment for Morton's syndrome, even if the patient's acute pain disappears in almost 90% of cases. 

General information on Morton's neuroma

How big is a Morton's neuroma?

The size of a Morton's neuroma varies considerably, and the size of the neuroma also depends on the location and size of the compression on the nerve. Generally speaking, however, a neuroma can grow to the size of a grape.

It's worth remembering that Morton's diagnosis is usually accompanied on MRI by that of bursitis, which can affect the 2nd, 3rd or even 4th radii, and is often reactive. In such cases, the neuroma is clearly at the root of the problem, and must be treated as a priority.

When should Morton's neuroma be operated on?

As a painful condition that requires immediate attention, surgery for Morton's neuroma is usually indicated if symptoms do not improve with natural treatments such as physiotherapy, orthotics, orthoses and medication. 

However, neuroma surgery can be performed to relieve pressure on the nerve and reduce symptoms.

Who should be consulted about surgery for Morton's neuroma?

A specialist podiatrist or orthopedic surgeon can perform surgery to remove Morton's neuroma. In fact, orthopedic surgeons are trained to treat problems related to the joints and bones, while podiatrists are trained to treat problems related to the toes and feet. 

What is the procedure for Morton's neuroma?

Surgery to remove Morton's neuroma can be performed under general, local or regional anaesthetic, and takes place on an outpatient basis, i.e. over the course of half an hour and a day. The specialized surgeon will remove the tissue surrounding the nerve to relieve pressure and prevent recurrence. 

After surgery, a period of rehabilitation may be necessary. However, the type of operation chosen depends on the size of the neuroma and, as mentioned above, may involve either release or removal of the interdigital nerve.

Nevrome de morton operation convalescence

Morton's neuroma surgery generally brings excellent results in terms of pain relief. Normal walking can be resumed after 2 to 3 weeks. Sports activities are possible once the wound has healed completely, after around 4 weeks.e and 6th week.