[Treatment of XXXX by neurectomy. Apropos of 43 cases].

@entity1 @entity1183 @entity7529 @entity1939 @entity1230 @entity158 @entity2950
PURPOSE OF THE STUDY: @entity2950 is a frequent cause of @entity7529 . Its diagnosis is clinical but progress in medical imaging: ultrasound, evoked potentials and above all MRI allows an improvement of para-clinical diagnosis. MATERIAL AND METHODS: 48 @entity2950 were treated surgically between 1979 and 1990. That represents 46 feet in 43 @entity1 . Female predominance was clear with an average age of 53 years. The follow-up period was 6 years and 10 months. 3 @entity1 had @entity1230 . Medical treatment had been prescribed prior to surgery in 24 @entity1 (15 had injections, 9 orthopedic shoe inserts and 5 both injections and inserts). The interval between the first symptoms and surgery was long since it was on average of 3 years and 6 months. The @entity2950 was located 36 times in the third interdigital space. The initial incision was plantar 11 times dorsal 32 times. Only neurectomies were performed. The @entity2950 was very large 9 times. 10 @entity1 had treatment for other affections in the same operative time. RESULTS: At review, 41 feet were @entity1939 . Shoe wear was normal for 32 @entity1 . 12 @entity1183 and 7 commissural and @entity1183 were noted. 3 of 11 @entity1 operated by the plantar approach had a @entity158 . DISCUSSION: None of our cases had preoperative MRI because our most recent case has 4 years of evaluation. At the present time the MRI could contribute to diagnosis owing to good tissular differentiation. The neurectomy led to a total disappearance of @entity158 but @entity1183 was frequent. The dorsal approach induces cutaneous complication. Neurolysis induces a sensitive postoperative deficit but recurrence occurs in 77 per cent of cases after neurolysis. CONCLUSION: @entity2950 is located essentially in the third interdigital space. Neurectomy is a simple operation that often leads to recovery.
