Comparative analysis of dorsal nerve relocation versus dorsal neurectomy in the surgical management of Morton´s neuroma

M. Koti, M. Edwards, M. Parikh, J. McAllister, S.A. Hasan

Methods: Patients who underwent surgery for Morton´s neuroma via the dorsal approach between 2002 and 2014 were analysed. Data was collected using hospital computer database, an in-depth review of patient´s case notes, postal and telephonic questionnaires. Out of 76 patients in total, there were 40 in the Dorsal nerve relocation (DNR) and 36 in the Dorsal neurectomy (DN) groups. Primary outcome measures used were Coughlin´s overall patient´s satisfaction criteria. Secondary outcome measures were resolution of sensory symptoms and any footwear restrictions.

Results: This study shows excellent to fair results in 35 patients (87%) in the DNR and 30 patients (83%) in the DN groups. There were poor results in 5 patients (13%) the DNR group and 6 patients (17%) in the DN group. 31 patients (77%) had resolution of sensory symptoms in the toes in the DNR group where as it was in 23 patients (64%) in the DN group. 4 patients (10%) reported no change and 5 (13%) were worse after surgery in the DNR group were as in the DN group 7 patients (19%) reported no change and 6 patients (17%) were worse after surgery. 35 patients (88%) had no restriction in wearing any type of footwear in the DNR group when compared to 30 patients (83%) in the DN group. 5 patients (12%) in the DNR group and 6 patients (17%) in the DN group wore modified or shoes without heels.

Conclusion: Overall there was no significant statistical difference in the outcome of the two surgical procedures.