28055 Neurectomy, intrinsic musculature of foot

Name of the Procedure:

Neurectomy, Intrinsic Musculature of Foot
Common Name: Foot Nerve Surgery
Technical Term: Neurectomy for Intrinsic Foot Musculature

Summary

A neurectomy for the intrinsic musculature of the foot is a surgical procedure that involves removing or severing a nerve within the foot's muscles to relieve chronic pain or dysfunction.

Purpose

This procedure addresses chronic pain, muscle spasms, or dysfunction in the foot that has not responded to conservative treatments. The goal is to alleviate pain and improve foot function.

Indications

• Chronic foot pain unresponsive to other treatments.
• Muscle spasms or nerve problems within the foot.
• Conditions such as Morton's neuroma, neuropathy, or nerve entrapment.
• Patients who have not found relief from physical therapy, medications, or orthotics.

Preparation

• Fasting for at least 6 hours before the procedure.
• Adjust any medications as advised by the physician.
• Preoperative diagnostic tests, such as MRI or nerve conduction studies, to identify the affected nerve.

Procedure Description

1. The patient is positioned and given anesthesia.
2. An incision is made over the target area of the foot.
3. The surgeon identifies the affected nerve within the intrinsic muscles of the foot.
4. The nerve is carefully removed or severed to disrupt the pain signals.
5. The incision is closed with sutures, and a sterile dressing is applied.
   • Tools: Scalpel, forceps, surgical scissors, and nerve locators.
   • Anesthesia: Local or general anesthesia depending on the case.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic or podiatric surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

• Common risks: Infection, bleeding, and pain at the surgical site.
• Rare risks: Nerve damage, numbness, and complications from anesthesia.
• Possible complications: Wound healing issues and persistent pain.

Benefits

• Relief from chronic foot pain.
• Improved foot function.
• Enhanced quality of life.
• Benefits usually realized within weeks to months following recovery.

Recovery

• Post-procedure care includes keeping the foot elevated and applying ice.
• Pain management with prescribed medications.
• Limited weight-bearing and use of crutches if necessary.
• Typically, full recovery occurs within 4 to 6 weeks.
• Follow-up appointments to monitor healing and nerve function.

Alternatives

• Physical therapy
• Medication management (e.g., analgesics, anti-inflammatories)
• Nerve blocks
• Orthotic devices
• Pros of alternatives: Non-invasive, less recovery time.
• Cons of alternatives: May not provide lasting relief.

Patient Experience

• During the procedure: If under local anesthesia, the patient may feel pressure but should not feel pain.
• After the procedure: Some discomfort and swelling are expected. Pain is managed with medications.
• Comfort measures include elevating the foot and using cold packs.