Tendon surgery for Morton's?

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THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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I am quite sure that you are speaking of neuroma compression surgery, where the transverse inter-metatarsal ligament, and NOT a tendon is sectioned and the neuroma mass is repositioned in the hope of mitigating or eliminating the pressure on it which is what is thought to elicit the typical neuroma symptoms. It is a procedure which has been gaining favor among some podiatrists, but I personally favor excision of the neuroma. Advantages of the decompression surgery include the fact that there is not an opportunity for the creation of a stump neuroma or entrapment of the proximal nerve segment in scar tissue and there is generally no loss of sensation in the areas of the toe or toes served by the nerve having the neuroma. The disadvantage include the fact that the attempt at decompression may be insufficient, the neuroma is still present, thus it may continue to grow in size and is still a potential source of problems and there is generally continued sensation in the areas of the toe or toes served by the nerve which has the neuroma. But all surgery his its potential up and done sides. I would think that you would do well to inquire of your doctor his/her extent of experience with this procedure, the success rate in his/her hands and how it compares to his/her use of whatever other forms of surgical or invasive procedures for relief of neuroma he/she has attempted. Keep in mind that success/failure/complication rates have no relevance if not personally reflective of the personal work of the doctor whom you have selected. The knowledgeable selection of a quality doctor is perhaps the most important factor in predicting your chances of a successful outcome.

HERE'S WHAT I GENERALLY ADVICE ONE TO LOOK FOR IN A PODIATRIC SURGEON:

1. Real board certification . . There is ONLY ONE recognized surgical board in podiatric medicine, and that is the ABPS (American Board of Podiatric Surgery), the "American Board Division" and not simply the "Ambulatory Sub-Section" or some other so-called "Ambulatory" group. Don't be impressed by all the other organizations which the doctor claims to be a member of or even certified by. If your surgeon is board certified by the "American Board Division" of the ABPS he/she surely will have a certificate to that effect pridefully displayed in the office.

2. Hospital privileges at a well-respected hospital in your area. State Licensing Boards, which grant podiatric graduates license to practice within its state, really demand insufficient proof that the doctor is a good one. In fact, most licenses are granted prior to the private practice of the doctor, and unless he/she had done or subsequently does something R E A L Y bad, and does it often enough, and has been reported for same, the doctor will remain in good standing. Hospital privileges offer at least two advantages. Firstly, hospitals have a vested interest (financial and reputation) in providing good care. To obtain privileges on a hospital staff, a doctor must supply the credential committee with proof of adequate training, and an essentially clean record in practice. Then the individual department "credentials" the individual with a process know as "delineation of privileges," and so specifies which procedures he/she is qualified to perform, frequently based on actual surgical assessment by a qualified staff member. (Not all surgeons on a hospital staff will necessarily be permitted to perform all procedures for which he/she is legally allowed). Also, when surgery is performed in a hospital setting, rather than behind the walls of an office, the surgeon and his/her technical abilities are on display for peers to see, and they can't very easily or for very long be swept under the rug as can easily be done in the office.

3. Find out to what degree of respect your surgeon is held within the local medical community . . Not by his/her friends, but by his/her peers. Many states keep a database, available to the public, where the doctor's malpractice and disciplinary record may be checked.

4. The very last place to go is patient references, as most patients have no way of assessing the skills of their doctors. If they had successful surgery, he/she must be good, and if not, he/she must not be good. But more importantly, since most folks do not know what makes a good or bad doctor, they rate the personality, and when a surgeon is coming at your body parts with a sharp knife, personality is absolutely no consideration.

Surgery, as well as all medical treatments, always has the potential for failure and undesirable results. Part of being a good surgeon is in knowing how and when to deal effectively with the untoward event which do occur. There is no one best method for most surgeries, as not all similarly named conditions are exactly alike, and so procedures should be tailored to the individual case. That's another skill necessary for the good surgeon . . knowing what needs to be done and doing it effectively.

 

CORRECTION:
I mistakenly included the fact that there is continued sensation in the areas of the toe or toes served by the nerve with the neuroma in the disadvantages of the decompression surgery. That is obviously an advantage, not a disadvantage, although, in my experience, the loss of some of the sensation which is unavoidable when the neuroma is excised has not generally been a source of patient complaints.