Neuroma

Abstract

The third web space is the most common (66%) location for an interdigital neuroma. In 21% of patients, neuromas are present bilaterality. The pathogenesis is thought to be nerve entrapment due to repetitive compressive trauma of plantar nerve against transverse intermetatarsal ligament. A neuroma is actually best described as perineural fibrosis in most instances rather than a true neuroma, as a true neuroma shows irregular histologic nerve tissue proliferation. What is commonly referred to as a primary interdigital neuroma usually histologically shows signs of nerve degeneration, including degeneration of myelinated fibers, thickening of the epineurium and perineurium, thickening and hyalinization of the walls of the neural vessels, and concentric edema within the nerve.