Centrocentral Anastomosis with Autologous Nerve Graft Treatment of Foot and Ankle Neuromas

1996 ◽  
Vol 17 (2) ◽  
pp. 85-88 ◽  
Author(s):  
Cobi Lidor ◽  
Reginald L. Hall ◽  
James A. Nunley
Keyword(s):  
Peroneal Nerve ◽  
Autologous Transplantation ◽  
Nerve Graft ◽  
Superficial Peroneal Nerve ◽  
Foot And Ankle ◽  
Morton’S Neuroma ◽  
Gun Shot ◽  
Morton's Neuroma ◽  
Web Space ◽  
Objective Improvement

Painful neuromatas in the foot and around the ankle can be difficult to treat. Five patients of clinically and histologically proven neuromas underwent centrocentral union with autologous transplantation. Three patients had previous toe amputations involving multiple operations. One patient had failed multiple operative treatments for Morton's neuroma in his 3rd web space. One patient had a neuroma in his superficial peroneal nerve caused by a gun shot wound. All patients but one showed definitive subjective and objective improvement after centrocentral union with the interposed autologous nerve graft. The patient with “recurrent” Morton's neuroma had the least improvement. This technique can be recommended as an alternative for the prevention of painful stump neuromata.

scholarly journals Use of superficial peroneal nerve graft for treating peripheral nerve injuries

2016 ◽  
Vol 51 (1) ◽  
pp. 63-69
Author(s):  
Samuel Ribak ◽  
Paulo Roberto Ferreira da Silva Filho ◽  
Alexandre Tietzmann ◽  
Helton Hiroshi Hirata ◽  
Carlos Augusto de Mattos ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Peroneal Nerve ◽  
Nerve Graft ◽  
Superficial Peroneal Nerve ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

scholarly journals Isolated Intermetatarsal Ligament Release as Primary Surgical Management for Morton’s Neuroma

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0013
Author(s):  
Mohamed Abdelaziz ◽  
Kathryn Whitelaw ◽  
Gregory Waryasz ◽  
Daniel Guss ◽  
Anne Johnson ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Nerve Transection ◽  
Digital Nerve ◽  
Morton’S Neuroma ◽  
The Past ◽  
Symptom Exacerbation ◽  
Morton's Neuroma ◽  
Web Space ◽  
Neuroma Formation

Category: Midfoot/Forefoot Introduction/Purpose: While the precise pathoetiology of Morton’s neuroma remains unclear, nerve inflammation as a result of chronic entrapment from the overlying intermetatarsal ligament (IML) may play a role. Traditional surgical management involved common digital nerve transection with neuroma excision, but this procedure risks unpredictable formation of a stump neuroma and potential worsening of symptoms. Accordingly, the senior author has over the past six years espoused isolated IML release and common digital nerve decompression in lieu of nerve transection or neuroma excision as an alternative treatment strategy. We hypothesized that IML release offers effective pain relief and high patient satisfaction level as a surgical treatment for recalcitrant Morton’s neuroma without the risk of stump neuroma formation or symptom exacerbation. Methods: Medical records for all consecutive patients treated surgically with isolated single interspace IML release for symptomatic and recalcitrant Morton’s neuroma over a four year period at a large academic medical center were examined. Any adult patient with clinically diagnosed Morton’s neuroma who had failed at least three months of conservative treatment and who then underwent single-webspace IML decompression were included. Any patient who had less than three months postoperative follow up, had undergone revisional neuroma surgery, or had undergone additional procedures at the time of the IML release were excluded. Overall patient satisfaction as well as pre- and post-operative Visual Analog Pain Scale (VAS) assessments were recorded for all patients. Results: Eleven patients underwent isolated, single interspace IML decompression for Morton’s neuroma over this time frame. One of these patients had a neuroma localized to the second web space and 10 were localized to the third web space. Average follow-up was 10.8± 9 (3-32) months (Table 1). VAS pain scores averaged 6.4 ± 1.9 (4-9) preoperatively and decreased to an average of 1.5 ± 1.6 (0-5) at final follow up (P = 0.003). All patients reported significant pain improvement and an overall satisfaction with the procedure (would undergo it again). No patients returned to the operating room, there were no postoperative infection nor worsening of pain, and no other complications were reported. Conclusion: Isolated single interspace IML release of chronically symptomatic Morton’s neuroma shows promising short-term results regarding pain relief and overall patient satisfaction, with few complications and no demonstrated risk of recurrent neuroma formation, permanent numbness, or postoperative symptom exacerbation. The authors’ collective experience with this approach has been positive enough over the past six years to result in the entire abandonment of the practice of neuroma excision in this patient population.

Schwannoma of the superficial peroneal nerve presenting as web space pain

1995 ◽  
Vol 34 (6) ◽  
pp. 532-533 ◽  
Author(s):  
Cato T. Laurencin ◽  
Michael Bain ◽  
James J. Yue ◽  
Hyman Glick
Keyword(s):  
Peroneal Nerve ◽  
Superficial Peroneal Nerve ◽  
Web Space

scholarly journals Transient superficial peroneal nerve palsy after anterior cruciate ligament reconstruction

2016 ◽  
Vol 6 (2) ◽  
Author(s):  
Majed Alrowaili
Keyword(s):  
Anterior Cruciate Ligament ◽  
Peroneal Nerve ◽  
Male Subject ◽  
Cruciate Ligament ◽  
Complete Recovery ◽  
Neurological Status ◽  
Superficial Peroneal Nerve ◽  
Foot And Ankle ◽  
Lateral Meniscectomy ◽  
Anterior Cruciate

A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status.

The Variations of the Sensory Branches of the Superficial Peroneal Nerve Course and its Clinical Importance

2005 ◽  
Vol 26 (11) ◽  
pp. 942-946 ◽  
Author(s):  
Hulya Ucerler ◽  
'Z. Asli Aktan Ikiz
Keyword(s):  
Peroneal Nerve ◽  
Clinical Importance ◽  
Anatomical Variations ◽  
Cutaneous Nerve ◽  
Detailed Knowledge ◽  
Superficial Peroneal Nerve ◽  
Foot And Ankle ◽  
Crural Fascia ◽  
Type 3 ◽  
Single Branch

Background: Although the sensory branches of the superficial peroneal nerve (SPN) have different anatomical variations that are of clinical importance, little is known about their anatomic courses, branching patterns, or relationships to palpable osseous landmarks. 1 , 3 A detailed knowledge is necessary for surgical exposures about the foot and ankle, arthroscopic procedures, ankle block anesthesia, and SPN block for leg venography. Methods: Thirty lower cadaver limbs were dissected to assess the anatomic properties and the variations of the sensory branches of the SPN. Results: Three distinct branch patterns were determined. In Type 1 (63.3%), the nerve penetrated the crural fascia 80.15 ± 17.80 mm proximal to the intermalleolar line and then divided into the intermediate dorsal cutaneous nerve (IDCN) and the medial dorsal cutaneous nerve (MDCN) (classic type). In Type 2 (26.7%), the IDCN and MDCN arose independently from the SPN. In Type 3 (10%), the SPN penetrated the crural fascia 101.14 ± 70.27 mm proximal to the intermalleolar line as a single branch. This single branch had a similar course to the MDCN. Measurements in this study were obtained from palpable bony reference landmarks. Conclusion: Detailed knowledge about the SPN, IDCN, and the MDCN may decrease the damage to these nerves during operative procedures near the foot and ankle.

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