28080 Excision, interdigital (Morton) neuroma, single, each

Name of the Procedure:

Excision, Interdigital (Morton) Neuroma, Single

Summary

In layman's terms, this procedure involves the removal of a painful nerve growth (called a neuroma) located between the toes. It is commonly referred to as removing a Morton neuroma.

Purpose

The procedure addresses the pain and discomfort caused by Morton neuroma, a benign thickening of nerve tissue between the toes. The goal is to alleviate pain, improve foot function, and remove the neuroma to prevent further irritation.

Indications

• Persistent pain and inflammation between the toes (usually between the third and fourth toes)
• Numbness or tingling in the toes
• Difficulty walking due to foot pain
• Lack of improvement with conservative treatments like orthotics or medication

Preparation

• Patients may be required to fast for a few hours before the procedure, especially if general anesthesia will be used.
• Medication adjustments might be necessary, particularly blood thinners.
• Pre-operative assessments may include physical exams, imaging studies (like MRI or ultrasound), and blood tests.

Procedure Description

1. The patient is given local anesthesia to numb the area or general anesthesia for full sedation.
2. An incision is made on the top or bottom of the foot, depending on the neuroma's location.
3. The surgeon carefully identifies and excises (removes) the neuroma.
4. The incision is closed with sutures, and the foot is bandaged to protect the site.

The tools used may include surgical scalpels, forceps, and other standard surgical instruments.

Duration

The procedure typically lasts between 30 minutes to 1 hour.

Setting

This procedure is usually performed in an outpatient surgical center or hospital.

Personnel

• Surgeon (typically an orthopedic or podiatric surgeon)
• Anesthesiologist or nurse anesthetist
• Surgical nurse or assistant

Risks and Complications

• Infection at the surgical site
• Excessive bleeding or hematoma formation
• Nerve damage leading to numbness or tingling
• Persistent pain or recurrence of symptoms
• Adverse reaction to anesthesia

Benefits

• Significant reduction or complete elimination of foot pain
• Improved ability to walk and engage in daily activities
• High success rate and quick relief from symptoms

Recovery

• Post-procedure care includes keeping the foot elevated, ice application to reduce swelling, and avoiding weight-bearing activities.
• Pain management with prescribed medications.
• Sutures are typically removed after 1-2 weeks.
• Recovery time ranges from a few weeks to a couple of months, with most patients resuming normal activities within 4-6 weeks.
• Follow-up appointments are necessary to monitor healing.

Alternatives

• Conservative treatments like orthotic devices, anti-inflammatory medications, and corticosteroid injections.
• Physical therapy and lifestyle modifications.
• Radiofrequency ablation or cryotherapy to shrink the neuroma.

Patient Experience

During the procedure, the patient will feel minimal to no pain due to anesthesia. Post-operatively, they may experience discomfort, swelling, and require pain management for a few days. Most patients report significant improvement in pain and mobility within a few weeks.