Neuroma De Morton
El neuroma es una tumoración benigna que aparece en el nervio plantar, que posteriormente dará la sensibilidad a los dedos. El lugar más común de aparición de la lesión es el tercer espacio intermetatarsal, llamándose el neuroma que aparece en esta localización Neuroma de Morton
El origen de la tumoración parece venir a la compresión del nervio entre el ligamento intermetatarsal, muy duro e inelástico, que está dorsal a la lesión, y el suelo, unido a la compresión extrínseca que sufren los metatarsianos por ir el pie encerrado en un zapato. La compresión provoca fibrosis y cambios perineurales que ocasionan sintomatología al enfermo.
Al aparecer cambios en el nervio, este comienza a “quejarse”, con la típica sintomatología neurológica: dolor, dolor excesivo, cambios en la sensibilidad, hormigueo, calambre…
Radiofrecuencia en neuroma de morton
En estadios iniciales, una plantilla ortopédica puede amortiguar el impacto de la lesión contra el suelo y mejorar la sintomatología, sin ser una solución en sí misma. Las infiltraciones con glucocorticoides pueden mejorar el dolor de la lesión, siempre que estén puestas en el sitio indicado (intralesional). En estadios más avanzados, se puede quitar parte de la sensibilidad del nervio, que es puramente sensitivo sin ramas motoras, con inyecciones de alcohol ecoguiadas, una técnica muy útil y sin grandes contraindicaciones. En casos más complicados, se puede hacer una radiofrecuencia continua sobre el nervio y en ocasiones, seccionar el ligamento intermetatarsal por cirugía ecoguiada ultra mínimamente invasiva. En alguna ocasión se puede extirpar el neuroma, pero el cuerpo entiende que el nervio seccionado ha sido dañado e intenta constantemente crear nuevas terminaciones nerviosas, quedando en un número importante de pacientes secuelas tras la cirugía abierta o tradicional.
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