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June 25, 1982

Metatarsal Neuroma

JAMA. 1982;247(24):3314. doi:10.1001/jama.1982.03320490018019

To the Editor.—  In answer to a query about metatarsal neuroma (1982; 247:683), George E. Omer, MD, gives the usual treatment of the condition and the treatment of the occasional sequel to the operative treatmentamputation neuroma.However, he does not mention a possible way to avoid the amputation neuroma—an operation first suggested by Gauthier.1 He described the Mortonian symptom complex as resulting from squeezing of the digital nerve between the plantar aspect of the foot and the anterior edge of the deep plantar fascia or intermetatarsal ligament.For treatment, Dr Gauthier simply cuts the intermetatarsal ligament. He does not touch the nerve itself.In his article, Gauthier described 206 patients with a "cure" rate of 83% and 14.5% with improvement. Since nerve tissue was not cut or excised, no amputation neuromas developed after these operations.