Radiofrequency Ablation for the Treatment of Painful Neuroma

J Foot Ankle Surg. 2020 May-Jun;59(3):457-461. doi: 10.1053/j.jfas.2019.09.003.

Abstract

Mechanical compression of interdigital nerves beneath the deep transverse intermetatarsal ligament and between the metatarsal heads leads to painful irritation and possible fibrosis. Conservative measures of padding and injections often fail to provide long-term relief. Surgical excision provides definitive relief, but the procedure is not without risk. Incomplete excision and stump neuroma formation are a few of the possible complications associate with open excision. This retrospective cohort study was performed to provide a review of the available literature on the identification and treatment of interdigital neuromas and to examine the overall incidence of patient satisfaction after radiofrequency ablation as definitive treatment for interdigital neuroma formation. This study population consisted of 32 patients (25 females and 7 males with 1 patient having bilateral procedures) with a mean age of 46.3 ± 17 (range 31 to 65) years. For all procedures, the median patient satisfaction score was 92.5 (interquartile range 50 to 100) of 100, with a mean follow-up period of > 2.5 years. Only 1 patient in the study population reported no relief after 3 total procedures. Radiofrequency ablation offers a minimally invasive alternative with a short postoperative recovery course and considerably fewer complications compared with surgical excision of the intermetatarsal neuroma as described in prior reports.

Keywords: Morton's neuroma; alcohol sclerosis; deep transverse intermetatarsal ligament; interdigital neuritis; radiofrequency ablation.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Morton Neuroma / complications
  • Morton Neuroma / diagnosis
  • Morton Neuroma / therapy*
  • Pain / diagnosis
  • Pain / etiology
  • Pain / prevention & control*
  • Pain Measurement
  • Patient Satisfaction
  • Radiofrequency Ablation*
  • Recovery of Function
  • Retrospective Studies
  • Treatment Outcome