Should open surgery for Morton's neuroma involve a plantar or dorsal (forefoot) incision?
In a paper by Akermark et al. the author concluded that a plantar incision was a reliable, safe treatment of Morton's neuroma.
Despite this result and some similar studies, at The London Podiatry Centre we tend to perform a dorsal incision on the top of the foot when open surgery is required. This is because the Centre has encountered a number of patients from other clinics where a plantar incision has resulted in significant complication, namely scarring and discomfort which can be very difficult to manage.
At our Centre, plantar incisions are only undertaken for revision surgery where access to the nerve is further back thus requiring this approach. We would generally advise against an incision at the bottom of the foot, and this is consistent with the approach favoured by most Podiatric Surgeons in the UK.