The patient should be cautioned of the lag time before effects of the steroid are noted 38 . The surgery is usually performed at an outpatient facility under intravenous sedation and local nerve block. The dorsal approach is most commonly used, but the plantar approach may be justified in recurring cases. Complications include hematoma formation, vascular compromise, and contracted digits secondary to severing of the deep transverse metatarsal ligament and loss of the fulcrum for the lumbrical tendon that helps stabilize the toe 43 . Recurrent neuromas do occur, and the plantar approach toward resection is best 6 .
Some surgeons advocate prophylactic measures to minimize further adhesions or stump formations.
The best measure of prophylaxis is clear identification of the neuroma and its proper digital branches intraoperatively and complete resection. Michetti ML, Jacobs Sa. J Foot Surg. J Am Podiatry Assoc. Heel pain and body weight.