Interdigital neuroma: Intermuscular neuroma transposition compared with resection

This prospective, randomized study compares the treatment of an interdigita l neuroma (IDN) by the standard resection operation with a technique in whi ch the IDN is transposed into the inter-muscular space between the adductor hallucis and the interossei muscles after division of the digital nerves d istal to the IDN. The resection group contained 22 patients and 22 neuromas and the transposition group contained 22 patients and 23 neuromas. An inte rviewer, blinded as to the operative technique used, telephoned each patien t preoperatively, and at 1 month, 3 months, 6 months, 12 months, and 36-48 months postoperatively. The interviewer recorded the patient's reported pai n level on a numerical rating scale of 0 to 100. In the resection group the average pain level was slightly lower through the first 6 month period, bu t at the 12 month review the resection group had a slightly higher average pain level. At the 36-48 month survey the resection group again reported a greater average pain level and fewer asymptomatic patients. It was concluded that it is unnecessary to excise the IDN to obtain excelle nt relief of pain. It was also concluded that transposition of the IDN into an intermuscular position between the adductor halllucis and the interosse i muscles produced significantly better long term results than did the stan dard resection operation.