Treatment of primary interphalangeal neuroma

  Symptoms: Burning forefoot pain or pain in the 2nd, 3rd, or 4th metatarsophalangeal joint area of the sole of the foot, which can radiate to the toes and is especially prominent when wearing shoes. The pain does not extend upward beyond the ankle joint. The site of the pain is sometimes not clearly localized.  Etiology: The interphalangeal nerve in the plantar aspect of the foot is compressed during the distribution from the plantar aspect of the forefoot to the toes.  Treatment: 1.Conservative treatment: wear loose shoes with soft padding, padded metatarsal pads, orthopedic braces, acupuncture and massage, Chinese herbal fumigation, external compresses, internal Chinese medicine, and closed treatment.  2.Surgical resection: After conservative treatment, about half of the patients eventually need to undergo radical resection of interdigital neuroma.  Indications for surgery: conservative treatment is ineffective or aggravated, pain is located in the 3rd or 2nd toe web.  Contraindications to surgery: forefoot pain that is not clearly localized, pain that is not in the 3rd or 2nd phalanx.  Postoperative complications: recurrence of neuroma, painful incision, abnormal toe sensation.