Decompression; plantar digital nerve
CPT4 code
Name of the Procedure:
Decompression; plantar digital nerve
Common name(s): Morton’s Neuroma Surgery
Summary
Decompression of the plantar digital nerve, also known as Morton’s Neuroma Surgery, is a procedure to relieve pressure on a nerve in the foot. The surgery aims to reduce pain and improve mobility by correcting nerve compression typically associated with Morton’s neuroma.
Purpose
This procedure addresses the painful condition known as Morton’s neuroma, a thickening of tissue around a nerve leading to the toes. The goal is to alleviate chronic pain or discomfort in the ball of the foot and toes, allowing the patient to walk and perform daily activities without pain.
Indications
This procedure is indicated for patients experiencing:
- Persistent burning or sharp pain in the ball of the foot.
- Pain that radiates into the toes.
- Tingling or numbness in the affected area.
- Symptoms not relieved by conservative treatments like orthotics, medications, or lifestyle changes.
Preparation
Patients may be advised to:
- Fast for several hours before surgery.
- Adjust or temporarily discontinue certain medications as advised by their physician.
- Undergo a physical examination and imaging tests such as X-rays or MRIs for accurate diagnosis and surgical planning.
Procedure Description
- The patient is positioned, and the surgical site is sterilized.
- Local or general anesthesia is administered.
- A small incision is made near the affected area.
- The surgeon carefully exposes and decompresses the affected nerve by releasing surrounding tight structures.
- The incision is closed with sutures.
- A sterile dressing is applied to the site.
Tools used include a scalpel, surgical scissors, and possibly magnifying instruments. The procedure can be done under local anesthesia, sometimes combined with sedation.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
This surgery is usually performed in an outpatient clinic or an ambulatory surgical center.
Personnel
- Surgeon (usually a podiatrist or orthopedic surgeon)
- Anesthesiologist or nurse anesthetist
- Operating room nurse
- Surgical technologist
Risks and Complications
Common risks include:
- Infection
- Swelling
- Bleeding
- Scar tissue formation Rare complications may include:
- Nerve damage
- Chronic pain
- Recurrence of symptoms
Benefits
Benefits include significant relief from pain, reduced inflammation, and improved foot function. Many patients experience symptom improvement within weeks to months after the procedure.
Recovery
- Keep the foot elevated and limit weight-bearing activities.
- Use crutches or a special walking shoe if advised.
- Follow wound care instructions and attend follow-up appointments.
- Gradual return to normal activities over a few weeks.
Alternatives
- Conservative treatments: orthotics, physical therapy, medications.
- Minimally invasive procedures: steroid injections, cryotherapy.
- Radiofrequency ablation. Each alternative has its pros and cons, with surgery typically considered when conservative measures fail.
Patient Experience
Patients may feel some discomfort during recovery, which can be managed with pain medications and supportive measures such as icing and elevation. Most patients find long-term relief from symptoms and an improvement in quality of life after the procedure.