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Stump Neuroma Surgery

Posted by Claire on 8/26/04 at 03:27 (158717)

Hi. I would be grateful if one of the doctors could asvise me about the above procedure. I had morton's neuroma surgery in Nov 2002 and have recently been advised that i have stump neuroma's in both feet, which is very painful, all of the the time. The doctor said he can operate and the success rate is 50%, is this true? He can implant a peice of muscle onto the stump neuroma or if the nerve is too damaged, he can implant the nerve into another part of my foot. Please advise. Many thanks.

Re: Stump Neuroma Surgery

Darlene on 8/26/04 at 09:23 (158722)

Hi Claire.

I am not a doctor, but I have heard that stump neuroma surgery could be very successful if the surgeon goes in through the bottom of the foot. That is where the nerves are and the doctor could follow each nerve fibre to make sure they are taking it all away from the weight bearing part of your foot. You need to find a doctor who does a lot of plantar incisions with good success. I think you have to be totally non weight bearing for a few weeks while the incision heals or else you could have big problems. Another option is to go to a neurosurgeon who would do it with a microscope lens to ensure all the nerve fibres are taken care of.

Did you have neuromas removed from both feet in Nov. 02?

Re: Stump Neuroma Surgery

Claire on 8/26/04 at 09:49 (158725)

Hi Darlene. Thanks for your response. Yes i had a bi-laterall removel in nov 02. Where/How did you find out this information?
Do you have similar problems? Thanks again.

Re: Stump Neuroma Surgery

Darlene on 8/26/04 at 13:17 (158735)

Claire:

I have a morton's neuroma and have been doing research for years. My ortho who is very conservative tried to help me to avoid surgery. Then I heard about a new technique and had it done by a podiatrist without much experience. Now I have numerous problems including the original neuroma. In my case it is not a stump neuroma because the nerve was not removed. What I have learned from this is to get lots of opinions. I haven't decided what my next step will be yet, but I am moving forward very cautiously. I have been to 15 doctors in the past short while and each one taught me something new and useful.

The term 'stump neuroma' is often used whenever there is a regrowth of nerve tissue after a neurectomy which causes pain. In truth, anytime a nerve is cut, the end becomes a stump neuroma. Thus when a neuroma excision is performed, it is important to cut back far enough so that the ends of the nerve fibres (now stump neuromas) are away from weight bearing areas. This is easier to do from the bottom of your foot. If the doctor doesn't have a lot of experience with plantar incisions and if you do not follow their post op instructions well, you could end up with a painful scar on a weight bearing area of your foot.

Do lots and lots of research before you do more surgery. Try a search on this website for neuromas. There is a yahoo group on morton's neuroma. Another good website to ask questions is http://www.arch-pain.com/Questions_toc.htm .

Let us know how you make out.

Darlene

Re: Stump Neuroma Surgery

Pauline on 8/26/04 at 15:39 (158743)

Darlene,
Thank you for confirming what I've been posting about neruoma surgery for some time.

So many people seem to have the thought that 'it's only my feet' what is the big deal about having foot surgery. Today we even see people wanted it done for cosmetic reasons.

I've often said if people thought about their feet like they'd think about their eyes many more opinions would be sought prior to any surgical procedure.

Feet are taken for granted and the surgeries sound so innocent and easy, but the truth of the matter is avoid foot surgery at all cost and if and when you must have it do your homework ahead of time, seek several opinions and take nothing for granted.

Re: Stump Neuroma Surgery

Dr. Z on 8/26/04 at 16:27 (158747)

Darlene,

Did you development any hammer toe problem or metatarsal problems after your surgery to cut the ligament for neuroma pain

Re: Stump Neuroma Surgery Dr Z.

Claire on 8/26/04 at 16:33 (158749)

Hi Dr Z. Please can you offer advice on my original posting. thanks

Re: Stump Neuroma Surgery

Dr. Z on 8/26/04 at 16:39 (158751)

Claire,

A stump neuroma is where the end of the nerve typically becomes attached to the plantar surface ( capsule) of the metatarsal bone.
I would try using alcohol injections. IF no relief I would perform a plantar incision where you can see the stump of the neuroma and cut it back away from any of the weight bearing surface. Moving the end of the nerve into a muscle if it is availble.
I would first try the alchol injections The plantar approach gives you excellent vision to do this procedure

Re: Dr. Z.

Darlene on 8/26/04 at 18:04 (158757)

Not exactly a hammer toe, but the 4th met head dropped, so the 4th toe is a little different. I also developed quite a bit of pain in the 2nd interspace (surgery was 3rd). That continues 7 months post op. I tried new orthotics, cortisone etc. The MRI shows a fibrous proliferation in the 2nd webspace. From there I developed tts symptoms after walking funny for so long. It's turned into quite the nightmare.

Darlene

Re: Dr. Z.

Dr. Z on 8/26/04 at 21:15 (158765)

I have seen the dropping of a met head caused by neuroma surgery due to the ligament being cut. I did what is called a met head osteotomy and the patient is still pain free twenty years plus. Met displacment is a clinical evaluation and can't be determined by an x-ray. The physician know what he is liking for. If the met head is dropped you will have pain, feel like you are walking on a marble and have neuroma type pain

Re: Dr. Z.

Ed Davis, DPM on 8/26/04 at 22:10 (158770)

Good thread. We want to be a bit more certain of the diagnosis. This is where I would use sonography to look for a stump neuroma and where sonography has a slight edge over an MRI. The plantar approach is better for a stump neuroma because of the better exposure and the unlimited ability to trace the nerve backwards.
Ed

Re: Dr. Z.

Darlene on 8/26/04 at 22:10 (158771)

Dr. Z.:

Do you think this is what might be happening in my 2nd interspace? It's very difficult to walk on a hard service and I find myself lifting my foot rather than rolling over my met heads. I also have pain along my 2nd toe, but more towards the big toe side. The ligament that was cut, however, is in the 3rd web space.

Your thoughts are truly appreciated.

Darlene

Re: Dr. Z.

Dr. Z on 8/27/04 at 08:26 (158787)

Without seeing your foot. I would theory that the 3rd met displacement is causing the problem

Re: Stump Neuroma Surgery

Claire on 8/27/04 at 12:11 (158810)

Thanks. Can you please give me a rough idea of the success rate of surgery?

Re: Stump Neuroma Surgery

Jean on 1/15/05 at 01:57 (167224)

I had a morton's Neuroma removed 6 weeks ago and have been left with severe persistant pain. It has now been diagnosed as a stump neuroma. I am realy scared as I can barey walk and I am worried about my work and looking after my children. Please any advice about pain relief and further surgery?? Only positive comments please

Re: Stump Neuroma Surgery

Connie M on 1/30/05 at 18:34 (168170)

I just had a stump neuroma surgery on Thursday after 14 1/2 months of pain after the original neuroma surgery. The pain is less now than it has been. I don't know what will happen when I am able to start putting some weight on it in three weeks.

This time I had the surgery by an orthopedic surgeon who specializes in foot and ankles only. Before the surgery I had a contrast MRI that showed the location of the neuroma.

I hope this helps you. Now I wish I would not have waited so long.

I wish for the best for you.

Re: Stump Neuroma Surgery

Jenn S on 10/09/05 at 10:07 (184357)

Darlene, Please tell me the alternative surgery you had. I recently had a procedure that sounds like it may be similar to yours. Thanks Jenn

Re: Ligament Release Surgery?

Dee on 10/09/05 at 12:00 (184366)

Was this the surgery where they cut the ligament to make more room for the nerve? I had this done and it was a huge disaster. WAY worse off than before. Before I did sports and was active in every way. Now I have significant pain with every step. I eventually had the nerve taken out, but the other issues that resulted from the surgery are still there and much worse. I'm still searching for answers and feel angry that the pod said it was 90% successful. Perhaps his definition of success is that he gets paid. We're made to feel like we are the only ones it didn't work on. It is very hard to trust after being lied to.

Re: Dr. Z.

JaniceS on 8/09/07 at 10:48 (234116)

I've had a diagnosis of a Morton's Neuroma and surgery will take place very soon. I have read about cutting the ligament (DTML) and removing the neuroma and nerves. I have to chose between the 2 or have both which is what my surgeon recommends. Can you give me any advice. The neuroma is 'a good size' and I've been told this gives me a better success rate. But I worry that cutting the ligament will change the way my foot works and will create other problems with posture. I already have a pain in my thigh muscle caused by pronation because of the neuroma. Otherwise I am young, fit and heathly and used to being able to go jogging. Any information and examples would be really appreciated, many thanks.