Scotti, TM . :The lesion of Morton’s metatarsalgia (Morton’s toe). .AMA Arch Pathol 63::91. ,1957. .
Nora, PF, ED Nora, and E Ghislandi. :Morton’s metatarsalgia: a misconception. .Illinois Med J 127::155. ,1965. .
Morscher, E, J Ulrich, and W Dick. :Morton’s intermetatarsal neuroma: morphology and histological substrate. .Foot Ankle Int 21::558. ,2000. .
Bourke, G, J Owen, and D Machet. :Histological comparison of the third interdigital nerve in patients with Morton’s metatarsalgia and control patients. .Aust N Z J Surg 64::421. ,1994. .
Ruuskanen, MM, T Niinimaki, and P Jalovaara. :Results of the surgical treatment of Morton’s neuralgia in 58 operated intermetatarsal spaces followed over 6 (2–12) years. .Arch Orthop Trauma Surg 113::78. ,1994. .
Addante, JB, PS Peicott, KY Wong, et al. :Interdigital neuromas: results of surgical excision of 152 neuromas. .JAPMA 76::493. ,1986. .
Gudas, CJ and GM Mattana. :Retrospective analysis of intermetatarsal neuroma excision with preservation of transverse metatarsal ligament. .J Foot Surg 25::459. ,1986. .
Keh, RA, KK Ballew, KR Higgins, et al. :Long-term follow-up of Morton’s neuroma. .J Foot Surg 31::93. ,1992. .
Morton, TG . :A peculiar and painful affection of the fourth metatarsophalangeal articulation. .Am J Med Sci 71::37. ,1876. .
Durlacher, L . : “A Treatise on Corns, Bunions, the Diseases of the Nails and General Management of the Feet. ,” inCampbell’s Operative Orthopaedics. , Vol2:, edited byCrenshaw, A. , p917. ,Mosby. ,St Louis. ,1987. .
Kay, D and GL Bennett. :Morton’s neuroma. .Foot Ankle Clin N Am 8::49. ,2003. .
Valente, M, M Crucil, and V Alecci. :Operative treatment of interdigital Morton’s neuroma. .Chir Organi Mov 92::39. ,2008. .
Nissen, KI . :Plantar digital neuritis: Morton’s metatarsalgia. .J Bone Joint Surg Br 30::84. ,1948. .
Ochoa, J . :The primary nerve fiber pathology of plantar neuromas: a model of chronic entrapment. .J Neuropathol Exp Neurol 35::370. ,1976. .
Gauthier, G . :Thomas Morton’s disease: a nerve entrapment syndrome: a new surgical technique. .Clin Orthop 142::90. ,1979. .
Kaminsky, S, L Griffin, J Milsap, et al. :Is ultrasonography a reliable way to confirm the diagnosis of Morton’s neuroma? Orthopedics 20::37. ,1997. .
Meachim, G and MJ Abberton. :Histological findings in Morton’s metatarsalgia. .J Pathol 103::209. ,1971. .
Ha’Eri, GB, VL Fornasier, and J Schatzker. :Morton’s neuroma: pathogenesis and ultrastructure. .Clin Orthop Relat Res 141::256. ,1979. .
Betts, LO . :Morton’s metatarsalgia: neuritis of the fourth digital nerve. .Med J Aust 1::514. ,1940. .
McElvenny, RT . :The etiology and surgical treatment of intractable pain about the fourth metatarsophalangeal joint (Morton’s toe). .J Bone Joint Surg Br 25::675. ,1943. .
Giannini, S, P Bacchini, F Ceccarelli, et al. :Interdigital neuroma: clinical examination and histopathologic results in 63 cases treated with excision. .Foot Ankle Int 25::79. ,2004. .
Guiloff, RJ, JW Scadding, and L Klenerman. :Morton’s metatarsalgia: clinical, electrophysiological and histological observations. .J Bone Joint Surg Br 66::585. ,1984. .
Ringertz, N and L Unander-Scharin. :Morton’s disease: a clinical and patho-anatomical study. .Acta Orthop Scand 29::327. ,1959. .
Nissen, KY . :The etiology of Morton’s metatarsalgia. .J Bone Joint Surg Br 33::293. ,1951. .
Su, E, E Di Carlo, M O’Malley, et al. :The frequency of digital artery resection in Morton interdigital neurectomy. .Foot Ankle Int 27::801. ,2006. .
Graham, CE and DM Graham. :Morton’s neuroma: a microscopic evaluation. .Foot Ankle Int 5::150. ,1984. .
Yoon, SS, Y Ostchega, and T Louis. :Recent Trends in the Prevalence of High Blood Pressure and its Treatment and Control, 1999–2008. ,National Center for Health Statistics. ,Hyattsville, MD. ,2010. . NCHS Data Brief No. 48.
Amis, JA, SW Siverhus, and BH Liwnicz. :An anatomic basis for recurrence after Morton’s neuroma excision. .Foot Ankle Int 13::153. ,1992. .
Johnson, JE, KA Johnson, and KK Unni. :Persistent pain after excision of an interdigital neuroma: results of operation. .J Bone Joint Surg Am 70::651. ,1988. .
Banks, AS, G Vito, and T Giorgini. :Recurrent intermetatarsal neuroma: a follow-up study. .JAPMA 86::299. ,1996. .
The present study was conducted in an attempt to obtain consistent similarities among histologic findings of surgically excised neuromas. Secondly, we looked for a correlation between the presence of a neuroma with certain comorbidities.
A total of 22 specimens with a preoperative diagnosis of Morton’s neuroma were sent to the pathology laboratory, and evaluation was performed by a single pathologist.
Degenerative changes were seen in 59% of the specimens. Patient age showed trends toward affecting nerve fibrosis, nerve diameter, vessel obstruction, and degenerative changes. The most frequent comorbidity was hypertension, seen in 44% of the participants.
Significant histologic similarities among results were not seen; however, certain trends were discovered. Degenerative changes were appreciated in most specimens. Definite histologic findings of neuroma recur, but difficulty in consistent reproducibility may be related to factors such as age, sex, and comorbidities. (J Am Podiatr Med Assoc 103(3): 218–222, 2013)