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  • Neuroma Surgery Description

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    Old 04-13-2004, 09:00 AM   #1
    CJBermuda
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    Neuroma Surgery Description

    Description

    A neuroma is an abnormality of a nerve that has been damaged either by trauma or as a result of an abnormality of foot function. The most common location of neuromas is in the ball of the foot. In this area the nerve can become pinched and inflamed by the abnormal movement of the bones in the ball of the foot.

    As the condition progresses the nerve may become permanently damaged and surgical removal of the nerve may be necessary.

    The Surgery

    The surgical removal of forefoot neuromas is a relatively simple procedure. The surgery can be preformed using a local anesthesia in the doctor?s office or with intravenous anesthesia (twilight anesthesia) in an outpatient surgery center.

    Following administration of anesthesia, a skin incision is made on the top of the foot in the location of the neuroma. This is most commonly in the area between the second and third toes or between the third and fourth toes. An alternative surgical approach is to place the skin incision on the bottom of the foot in the location of the neuroma. Most surgeons prefer to make the skin incision on the top of the foot for several reasons. If the skin incision is placed on the bottom of the foot the patient may be required to use crutches for up to three weeks. Additionally, it takes longer for the skin on the bottom of the foot to heal. In the event that a thicken or irregular scar forms during healing, it may cause pain while walking. When the incision is made on the top of the foot the neuroma is easily found between the long bones (metatarsals) behind the toes. After the nerve is identified it is cut and removed. Once the surgery is completed a gauze dressing is applied. This bandage stays in place until the surgeon sees the patient on their first post-operative visit. On the first post-operative visit the surgical site is inspected and a new dressing is applied. The sutures are removed in 10 ? 14 days following the surgery. During this period of time the foot must remain dry to reduce the risk of infection. The patient should limit their activities and keep their foot elevated above the heart as much as possible. A post-operative shoe is worn which allows the patient to do limited walking. The patient should not walk with out the post-operative shoe. Once the sutures have been removed the patient may bath the foot and attempt to wear a roomy stiff-soled walking shoe. It generally takes three weeks from the time of surgery before the walking shoe can be worn comfortably.

    Recovery Time

    The time required to be off from work will depend upon the type of work being preformed and the type of shoe that must be worn. If the patient can work with their foot propped up and elevated with limited walking they may be able to return to work within a week of surgery. It is generally recommended that the patient not return to work until they can wear a normal shoe comfortable. Patients who have jobs that require prolonged standing, walking, kneeling or climbing may be off from work for as long as four to six weeks.

    Possible Complications

    The surgery has an over all high success rate, however as with any surgery complications can occur. Possible complications include infection, excessive swelling, and delays in healing or continued pain. Also when a nerve is cut there is a small possibility that the nerve may grow abnormally producing a stump neuroma. If the patient walks on the foot more that what is recommended excessive swelling can cause bleeding or scaring that may result in continued pain and delays in healing.

     
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    Old 04-13-2004, 09:14 AM   #2
    ronnald
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    Re: Neuroma Surgery Description

    Some people also say it makes their toe(s) numb, but they say they'll take numb toes over the pain anyday.

     
    Old 04-13-2004, 09:23 AM   #3
    CJBermuda
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    Angry Re: Neuroma Surgery Description

    Ronald,

    I think I am ready to agree with your statement. Today is really bad for me. I went salsa dancing on Sat night, wore 2 inch dancing shoes, wore cute shoes to work yesterday. IT has been very warm here in Bermuda and I wanted to enjoy the weather tooo. So now I am really pay for the beauty....

    Today I am back in flat shoes and socks!!!

    Pain with Tears today.....

    thanks
    CJ..

    Last edited by CJBermuda; 04-13-2004 at 09:26 AM.

     
    Old 04-13-2004, 09:50 AM   #4
    ronnald
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    Re: Neuroma Surgery Description

    CJ, yesterday I worked out on the stairmaster, I thought I would be OK. I'm paying today too. Although my podiatrist now thinks this is Bursitis. But symptoms seem somewhat similar.

     
    Old 04-13-2004, 09:52 AM   #5
    CJBermuda
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    Red face Re: Neuroma Surgery Description

    Ronald,

    I guess we are feeling each others pain on this one....

    it is very hard when you are active to limit yourself to doing almost nothing. Some days I feel really horrible when I have not worked out. I will have a great workout next week before the surgery though...

    Here is to staying fit... even if it hurts A LOT!!!!

    CJ...

    Last edited by CJBermuda; 04-13-2004 at 09:53 AM.

     
    Old 04-13-2004, 10:05 AM   #6
    ronnald
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    Re: Neuroma Surgery Description

    Thanks CJ

    The funny thing is, we work out to improve our health and look what happens...We end up having problems. LOL

    Anyway, yesterday I was at the gym and all the eleptical machines were taken so I figured I'd get back on the stairmaster (which I did for several years before my feet went bad). After 5 minutes I noted my feet were starting to hurt, so I got off.

    Oh, I also have to ice my foot half way through my time on the eleptical machine. Helps my foot and lets me go another 20 minutes. I bring in one of those blue ice things you put in coolers, I just step on it for several minutes.

     
    Old 04-13-2004, 12:08 PM   #7
    ronnald
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    Re: Neuroma Surgery Description

    CJ,

    I just came back from my podiatrist...After a pretty thorough exam she said it was neuromas. She showed me where and said I have two of them, and they made a clicking sound. I asked her if it's possible I could have another, she said it's possible, but was hesitant to say for sure.

    She really wants me to try all avenues with orthodics before proceding to anything else at this time. I was happy to hear that.

     
    Old 04-13-2004, 12:18 PM   #8
    CJBermuda
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    Re: Neuroma Surgery Description

    Ronald,

    I meant to ask you if you had the clicking sound. My surgeon found the clicking sound last week, where as other dr's where not able to find it on my foot.

    So I guess it is official you have neuromas..

    Are you goin gto do the alcohol injection??

     
    Old 04-13-2004, 01:22 PM   #9
    ronnald
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    Re: Neuroma Surgery Description

    CJ,

    Next week I'm getting married, so anything like that will have to wait. My podiatrist really wants me to try all the different orthodics first. She even said it will be frusterating at times, but she said she can inject me if I wanted, I declined for the time.

    If it does come down to it, I think I will do an alcohol injection before surgery.

    Have you tried the alcohol? (I think I already asked that before, sorry)

     
    Old 04-13-2004, 01:39 PM   #10
    CJBermuda
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    Re: Neuroma Surgery Description

    Ronald,

    No, I have exceeded all limits on injections. I have had 3 cortizone injections. Think they have made things worse for me. Plus my foot looks like I have no circulation in one spot....

    Congratulations on the marriage!!! I wish you and your intended all the best!!!

    I hope that you are pain free for your special day..
    take care
    CJ..

     
    Old 04-13-2004, 01:56 PM   #11
    ronnald
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    Re: Neuroma Surgery Description

    Thanks CJ

    I plan on not exercising for the few days prior to the wedding so, I should be "ok" but standing makes my feet hurt too. And taking high doses of Advil makes my tinnitus louder (I have loud tinnitus, err ear ringing).

    But wouldn't alcohol injections and cortizone injections be different? Alcholol is suppose to deaden the nerves, does it also weaken the surrounding tissue like cortizone?

     
    Old 04-13-2004, 02:08 PM   #12
    CJBermuda
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    Re: Neuroma Surgery Description

    I believe it does weaken the tissues like cortizone.
    There was a thread a week or so ago that spoke specifically on Alcohol injections, most folks said they are just as bad a cortizone injections....

    Try lots of icing and resting before the wedding so that you will be pain free. Try to wear shoes that have a hard sole for protection and get some gel pads or metatarsal pads for your shoes. Something that is comfortable and you would hardly know that it is in your shoe.

    take care
    CJ.

    Last edited by CJBermuda; 04-14-2004 at 09:28 AM.

     
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