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Interdigital Neuritis: Diagnosis and Treatment

Department of Orthopaedics, Mount Sinai School of Medicine, New York, and Mount Sinai Medical Center.

Because it has not yet been established whether the condition commonly referred to as Morton's neuroma results from true neuromatous proliferation or from inflammation in the region of the interdigital nerve, the term "interdigital neuritis" is preferred. The authors review the etiology, diagnosis, and management of interdigital neuritis, including whether a plantar or dorsal approach is preferable and whether neurectomy is more efficacious than incision of the transverse metatarsal ligament, with or without neurolysis. The authors recommend that diagnosis be made on the basis of the history and clinical examination, that surgery be performed through a dorsal approach with release of the transverse ligament but without neurectomy, and that revision surgery be performed through a dorsal incision with excision of the nerve 3 cm proximal to the transverse ligament.