Name: Morton's Neuroma Excision (HD Detailed Surgical Video)
Uploaded: 2024-05-31T00:00:00.0000000
Duration: T00H05M00S
Description: Morton's Neuroma Excision (HD Detailed Surgical Video)

Name: Morton's Neuroma Excision (HD Detailed Surgical Video)

Description: Morton's Neuroma Excision (HD Detailed Surgical Video)

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Upload Date: 2024-05-31T00:00:00.0000000

Transcript: Language: EN.
Segment:0 .
So today, we are going to do an excision work on the Morton's Neuroma on an 18-year-old boy. He's been suffering with this for the last three years, unfortunately. He visited quite a few orthopaedic doctors, but no one was able to diagnose. And then he self searched about this problem and was he came to me and with the diagnosis of Morton's Neuroma. Clinically he had been to the space we did an ultrasound stand with showed neuroma.
It was further confirmed by an MRI. He is a professional rugby player at a national level and is quite double wide so we are going to excise him today. So our landmark will be its typically present and the 1/3 of a space between third and fourth floor. So there are two approaches. You can go dorsal and you can go plantar and plantar can be vertical or horizontal. So the different surgeons have different approach.
I usually prefer dorsal approach because this allows patients to weight bear pretty much straight away after the surgery. If you use plantar approach, then there may be an issue with weight bearing immediately afterwards and sometimes you can have problems with healing. However, many authors or many surgeons would disagree with me, but my preferred approach is dorsal approach.
So my incision is between third and fourth web space. So we would leave the section. You did have opportunity and you did not. The doctor said, I want an injection. And you can see this whitish discoloration, which is usually associated with steroid injection. So again, they find something that the cells veins superficially, which we are going to cauterize
and divide. We're done with the superficial dissection. Could you pass the forceps. Thank you. I'm just going to
Under section. To please. I'm just going to pop in a sulphradiner. So you can see this is the head of the third metatarsal. This is the head of the fourth metatarsal. We are in the third inter-metatarsal space of air space.
You start seeing some intro shade here. So I think now is about to come into visibility very soon. I think I can see it. So now your main landmark is inter-metatarsal ligament between, which is between third between the third and fourth metatarsal. So you need something to open up. So I would ask my assistant.
I don't have access to landmark spreader here. If I can ask my assistant to open the web space like this. Let's have that 90 degree. OK so you can clearly see the nerve here.
So the nerve is about to be visible. You can see it's taken there. Yeah so I'm holding this neuroma in my forceps, so I'm just going to clear it out a little bit. So you can see the neuroma here. My, I'm just dissecting the neuroma. So you can see it is so big.
Normally, the distal nerves are not that big. They are actually very, very small. So now we need to clear it up a little bit more so that we can excisis. But I want to release it distally so that I can see the nerve.

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