‣What is it? What nerve involved?It is the compressive neuropathy of the common plantar interdigital nerveNot a true neuroma.‣What is the interdigital nerve? Interdigital nerve = confluence branches of lateral and medial plantar nerves‣What is the histology?Perineurial fibrosis, degeneration of nerve fibres‣Clinical finding?Mulder’s click - squeeze forefoot while palpating webspace to feel flick‣Investigation?MRI‣What is non op management?Wide shoe box, steroid injection‣How effective is H and L injection? H and L injection - Markovic et al. 2008 FAI journal - 38% completely resolve after steroid injection. 39 injections under US guidance66% positive outcomes. (38% complete satisfaction, 28% satisfied)journals.sagepub.comjournals.sagepub.com‣Surgical technique for morton neuroma?NeurectomyDorsal approach recommended as plantar approach may lead to painful scarNerve is deep to transverse inter metatarsal ligament - divide itExcise nerve 2-3cm proximal to bifurcation‣Complications of surgery?Stump NeuromaMost common due to Inadequate retraction of the whole nerve (traction neuritis). Inadequate resection due to: i.e. not proximal enough Nerve should be resected to at least 3cm proximal to inter metatarsal ligamentPainful plantar scarIncreased risk with plantar incision