Does Greek Foot Predispose to Morton’s Neuroma?


Background: Morton’s neuroma is the enlargement of an interdigital nerve most commonly located between the third and fourth metatarsals. Greek foot is a normal variant where the first metatarsal is shorter than the second metatarsal. To our knowledge, there is currently no reported association between Greek foot and Morton’s neuroma in the literature. Methods: Retrospective study of 184 patients. Two separate cohorts were recruited. Cohort A comprised of 100 randomly selected asymptomatic patients. Cohort B comprised of 84 patients with a history of foot pain and histologically confirmed Morton’s neuroma. Foot shape was determined by using a self-assessment tool and plain radiographs. Statistical analyses were performed using the Chi-square test on the association between Greek foot and Morton’s neuroma. A p-value of <0.05 was considered statistically significant. Results: Our study shows a statistically significant association between Greek foot and Morton’s neuroma with a prevalence of Greek foot in Cohort A of 20% and in Cohort B of 63%. (p = 2.6 × 10﹣9). Conclusions: This study has shown a possible association between the presence of a Greek foot and the presence of Morton’s neuroma. Although our study design has limitations and does not allow full statistical analysis, we do believe that the shown association between Greek foot and Morton’s neuroma can help clinicians and other health care providers in establishing the diagnosis of Morton’s neuroma in patients with a painful foot.

Share and Cite:

Jump, C. , Rice, M. , Gheorghiu, D. and Sanchez-Ballester, J. (2014) Does Greek Foot Predispose to Morton’s Neuroma?. Open Journal of Orthopedics, 4, 176-182. doi: 10.4236/ojo.2014.47029.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Durlacher, L. (1945) A Treatise on Corns, Bunions, the Diseases of Nails, and the General Management of Feet. Simpkin, Marshall and Co., London.
[2] Morton, T. (1876) A Peculiar and Painful Affection of the Fourth Metatarso-Phalangeal Articulation. American Journal of the Medical Sciences, 71, 37-45.
[3] Lorimer, D.L. and Neale, D. (2002) Neale’s Disorders of the Foot: Diagnosis and Management. 6th Edition, Churchill Livingstone, Edinburgh, New York, 714 p.
[4] Brubaker, N. (2008) Morton’s Neuroma. The Journal of Nursing, 4, 785-786.
[5] Bencardino, J., Rosenberg, Z.S., Beltran, J., Liu, X. and Marty-Delfaut, E. (2000) Morton’s Neuroma: Is It Always Symptomatic? American Journal of Roentgenology, 175, 649-653.
[6] Dereymaeker, G., Schroven, I., Steenwerckx, A. and Stuer, P. (1996) Results of Excision of the Interdigital Nerve in the Treatment of Morton’s Metatarsalgia. Acta Orthopædica Belgica, 62, 22-25.
[7] Nissen, K.I. (1948) Plantar Digital Neuritis; Morton’s Metatarsalgia. Journal of Bone and Joint Surgery, 30B, 84-94.
[8] Gauthier, G. (1979) Thomas Morton’s Disease: A Nerve Entrapment Syndrome. A New Surgical Technique. Clinical Orthopaedics and Related Research, 142, 90-92.
[9] Bossley, C.J. and Cairney, P.C. (1980) The Intermetatarso-Phalangeal Bursa—Its Significance in Morton’s Metatarsalgia. Journal of Bone and Joint Surgery, 62, 184-187.
[10] Wu, K.K. (1996) Morton’s Interdigital Neuroma: A Clinical Review of Its Etiology, Treatment, and Results. Journal of Foot and Ankle Surgery, 35, 112-119.
[11] Addante, J.B., Peicott, P.S., Wong, K.Y. and Brooks, D.L. (1986) Interdigital Neuromas. Results of Surgical Excision of 152 Neuromas. Journal of the American Podiatric Medical Association, 76, 493-495.
[12] Bradley, N., Miller, W.A. and Evans, J.P. (1976) Plantar Neuroma: Analysis of Results Following Surgical Excision in 145 Patients. Southern Medical Journal, 69, 853-854.
[13] Coughlin, M. and Mann, R. (2001) Foot and Ankle Surgery. Mosby, St Louis.
[14] Jones, J.R. and Klenerman, L. (1984) A Study of the Communicating Branch between the Medial and Lateral Plantar Nerves. Foot & Ankle International, 4, 313-315.
[15] Betts, L. (1940) Morton’s Metatarsalgia. Medical Journal, 1, 514-515.
[16] Mulder, J.D. (1951) The Causative Mechanism in Morton’s Metatarsalgia. Journal of Bone and Joint Surgery, 33, 94-95.
[17] Terk, M.R., Kwong, P.K., Suthar, M., Horvath, B.C. and Colletti, P.M. (1993) Morton Neuroma: Evaluation with MR Imaging Performed with Contrast Enhancement and Fat Suppression. Radiology, 189, 239-241.
[18] Resch, S., Stenstrom, A., Jonsson, A. and Jonsson, K. (1994) The Diagnostic Efficacy of Magnetic Resonance Imaging and Ultrasonography in Morton’s Neuroma: A Radiological-Surgical Correlation. Foot & Ankle International, 15, 88-92.
[19] Zanetti, M., Strehle, J.K., Zollinger, H. and Hodler, J. (1997) Morton Neuroma and Fluid in the Intermetatarsal Bursae on MR Images of 70 Asymptomatic Volunteers. Radiology, 203, 516-520.
[20] Sharp, R.J., Wade, C.M., Hennessy, M.S. and Saxby, T.S. (2003) The Role of MRI and Ultrasound Imaging in Morton’s Neuroma and the Effect of Size of Lesion on Symptoms. Journal of Bone and Joint Surgery, 85, 999-1005.
[21] Bennett, G.L., Graham, C.E. and Mauldin, D.M. (1995) Morton’s Interdigital Neuroma: A Comprehensive Treatment Protocol. Foot & Ankle International, 16, 760-763.
[22] Mann, R.A. and Reynolds, J.C. (1983) Interdigital Neuroma—A Critical Clinical Analysis. Foot & Ankle International, 3, 238-243.
[23] Friscia, D.A., Strom, D.E., Parr, J.W., Saltzman, C.L. and Johnson, K.A. (1991) Surgical Treatment for Primary Interdigital Neuroma. Orthopedics, 14, 669-672.
[24] Anwar, F. (2010) Morton’s Neuroma-Outcome of Surgical Excision. Journal of Orthopaedics, 7, e8.
[25] Hoadley, A.E. (1893) Six Cases of Metatarsalgia. Chicago Medication Reconciliation, 5, 32.
[26] McGlamry, E.D. and Banks, A.S. (2001) McGlamry’s Comprehensive Textbook of Foot and Ankle Surgery. 3rd Edition, Lippincott Williams & Wilkins, Philadelphia, 66 p.
[27] Thomson, C.E., Gibson, J.N. and Martin, D. (2004) Interventions for the Treatment of Morton’s Neuroma. Cochrane Database of Systematic Reviews, 3, Article ID: CD003118.
[28] Hamilton, W.G. (1992) Morton’s Neuroma Surgery. The Foot: Surgical Update Seattle. AAOS Summer Institute, Washington DC.
[29] Coughlin, M.J. and Pinsonneault, T. (2001) Operative Treatment of Interdigital Neuroma. A Long-Term Follow-Up Study. Journal of Bone and Joint Surgery (American Volume), 83, 1321-1328.
[30] Sing, S.K., Ioli, J.P. and Chiodo, C.P. (2005) The Surgical Treatment of Morton’s Neuroma. Current Orthopaedics, 19, 379-384.
[31] Johnson, J.E., Johnson, K.A. and Unni, KK. (1988) Persistent Pain after Excision of an Interdigital Neuroma. Results of Reoperation. Journal of Bone and Joint Surgery (American Volume), 70, 651-657.
[32] Beskin, J.L. and Baxter, D.E. (1988) Recurrent Pain Following Interdigital Neurectomy—A Plantar Approach. Foot & Ankle International, 9, 34-39.
[33] Schimizzi, A. and Brage, M. (2004) Brachymetatarsia. Foot and Ankle Clinics, 9, 555-570.
[34] Morton, D. (1927) Metatarsus Atavicus: The Identification of a Distinct Type of Foot Disorder. Journal of Bone and Joint Surgery (American Volume), 9, 531-544.
[35] Coughlin, M.J. (2000) Common Causes of Pain in the Forefoot in Adults. Journal of Bone and Joint Surgery, 82, 781-790.

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.