Morton neuroma is a compressive neuropathy of the forefoot interdigital nerve. Neuropathy is chiefly due to compression and irritation at the plantar aspect of the transverse intermetatarsal ligament. It is not a true neuroma as the condition is degenerative rather than neoplastic. It is also referred to as Morton metatarsalgia, interdigital neuritis, Morton entrapment, interdigital neuralgia, interdigital neuroma, interdigital nerve compression syndrome, and intermetatarsal neuroma. The most common location for Morton neuroma is between the 2nd and 3rd metatarsals.

Myriad pathologies affect the lesser toes. In this article, the focus is on the challenging radiological differential diagnosis of plantar plate (PP) degeneration and tear versus webspace neuroma. It is now understood that PP tear and even degeneration without tear is most accompanied by reactive pericapsular soft tissue thickening (pseudoneuroma), which contributes to neuritic symptoms that are often indistinguishable from webspace neuroma. In this article, the authors will review the differing clinical presentations and radiographic, sonographic, and MRI findings of these entities and the different acquired toe deformities that occur in PP dysfunction with pseudoneuroma, versus webspace neuroma.

Nodular soft tissue abnormalities are common in the foot and ankle and often demonstrate overlapping magnetic resonance imaging features, typically showing high signal intensity on T2-weighted sequences. In contrast, T2-weighted hypointense soft tissue nodules are less common and encompass a range of neoplastic and pseudotumoral entities. Among these, Morton's neuroma is likely the most prevalent abnormality; however, other less common but clinically relevant lesions may appear with similar imaging features.

It is rare for patients to present to the plastic surgery department with foot pain. If this occurs, there is a high probability that these are patients who would have visited numerous hospitals without finding a solution to their complaints and have not recovered despite receiving various treatments. In such cases, Morton's neuroma is a diagnosis that remains unseen by the eyes unless it is kept in mind. Following its correct diagnosis, surgical treatment is definitely within the scope of plastic surgery. In this report, we present two male patients, aged 35 and 40 years, treated in our clinic for chronic pain and burning sensation in the third intermetatarsal space. Both patients underwent surgical excision of the neuroma via a dorsal approach. Postoperatively, both patients reported significant improvement in their symptoms and returned to daily activities without complications. Although foot pain is primarily associated with orthopedics, Morton's neuroma is an interdigital nerve pathology that requires precise surgical management. We conclude that plastic surgeons should not hesitate to diagnose and treat this condition, as it falls well within their area of expertise.

Heel pain is a very common foot condition. Mechanical factors are the most common cause of heel pain. The main causes of heel pain include plantar fasciitis, heel spurs, Achilles tendinopathy, heel neuritis, and heel bursitis. This case study aimed to manage pain in a patient with heel pain accompanied by pronounced pes planus. A 42-year-old woman presented with heel pain and pes planus. The pain was present in the normal standing position and at rest. After examination, a spur, plantar fasciitis, and Morton's neuroma were diagnosed. The patient, who had not responded to medical and rehabilitative treatments, was evaluated using the visual analog scale and the 36-Item Short Form Survey quality of life questionnaire to assess pain during rest and walking using a newly developed combined exercise method. Significant improvements were observed in the final measurements. This study contributes significantly to our knowledge of the best physiotherapy treatments for patients with heel pain associated with spurs and plantar fasciitis.

Morton's neuroma (MN) is frequently refractory to conventional conservative therapies, and surgical excision carries the risk of recurrent pain. While extracorporeal shock wave therapy (ESWT) has emerged as a potential non-invasive intervention for MN, a standardized clinical protocol for its application remains to be established. This review aims to elucidate the physiological validity of ESWT for MN and propose an optimized clinical protocol. Existing randomized controlled trials of ESWT for MN were analyzed, and findings from other entrapment neuropathies were extrapolated to critically appraise interventional factors influencing therapeutic outcomes. ESWT exerts a biphasic effect: immediate analgesia via the degeneration of free nerve endings, and radical pathophysiological improvement through the promotion of neovascularization and tissue repair. The present analysis suggests that the use of local anesthesia may inhibit mechanotransduction, potentially reducing success rates. Furthermore, considering the dynamics of growth factors involved in tissue regeneration, multiple sessions at one-week intervals are more rational than a single application. Optimizing ESWT through repetitive sessions without anesthesia at the maximum tolerable energy flux density may maximize therapeutic efficacy. ESWT is expected to become an integral, minimally invasive standard therapy that precludes the necessity for surgical intervention.