scholarly journals Operative treatment options for Morton’s neuroma other than neurectomy - A systematic review

2021 ◽  
Author(s):  
Jun Young Choi ◽  
Woi Hyun Hong ◽  
Min Jin Kim ◽  
Su Whi Chae ◽  
Jin Soo Suh
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Treatment Options ◽  
Morton’S Neuroma ◽  
Morton's Neuroma

A Systematic Review of Ultrasound-Guided and Non–Ultrasound-Guided Therapeutic Injections to Treat Morton's Neuroma

2014 ◽  
Vol 104 (4) ◽  
pp. 337-348 ◽  
Author(s):  
Peter Morgan ◽  
Wendy Monaghan ◽  
Simon Richards
Keyword(s):  
Systematic Review ◽  
Ultrasound Guidance ◽  
Extraction Process ◽  
Evidence Base ◽  
Injection Therapy ◽  
Ultrasound Guided ◽  
Morton’S Neuroma ◽  
Painful Condition ◽  
Therapeutic Outcomes ◽  
Morton's Neuroma

Background Morton's neuroma is a frequently painful condition of the forefoot, causing patients to seek medical care to alleviate symptoms. A plethora of therapeutic options is available, some of which include injection therapies. Researchers have investigated injection therapy for Morton's neuroma, and latterly the evidence base has been augmented with methods that use diagnostic ultrasound as a vehicle to deliver the injectate under image guidance for additional accuracy. To date, there seems to be no consensus that ultrasound-guided injections provide better therapeutic outcomes than nonguided injections for the treatment of Morton's neuroma. Methods A systematic review was chosen because this method can undertake such a process. The review process identified 13 key papers using predetermined inclusion and exclusion criteria, which then underwent methodological quality assessment using a pretested Quality Index. A narrative synthesis of the review findings is presented in light of the heterogeneity of the data from the extraction process. Results This systematic review provides an argument that ultrasound guidance can produce better short- and long-term pain relief for corticosteroid injections, can reduce the need for additional procedures in a series of sclerosing alcohol injections, can reduce the surgical referral rate, and can add efficacy to a single injection. Conclusions Ultrasound guidance should be considered for injection therapy in the management of Morton's neuroma.

scholarly journals Interdigital Perineural Fibroma And A Care Pathway.

2020 ◽  
Author(s):  
Mark Price ◽  
Andrew Bridgen
Keyword(s):  
Surgical Approach ◽  
Care Pathway ◽  
Treatment Options ◽  
Surgical Excision ◽  
Outcome Data ◽  
Mixed Methods Design ◽  
Morton’S Neuroma ◽  
Audit Data ◽  
Significant Difference ◽  
Morton's Neuroma

Abstract BackgroundInterdigital perineural fibroma (IPF) is a complex condition affecting the plantar nerve of the foot and the care pathway for its management is based upon a consensus of clinical opinions. AimThe aim of the study was to investigate the treatment outcomes within a podiatric surgical practice and produce a validated care pathway over a three-year period.MethodsA retrospective mixed methods design was used to allow combination of quantitative and qualitative data. 89 patients between 1/4/2014 and 1/4/2017 had completed PASCOM-10 audit data. The treatment options were investigated and the MOXFQ domains and PSQ10 outcome scores were subject to analysis with SPSS.FindingsThe mean age of patients in the study was 56 (range 36-86, SD 10.85) and 89% were female, 11% male. 749 patients out of the total caseload had local anaesthetic/steroid injections over the three-year period, of which 49% of the known injections were for Morton’s Neuroma. No outcome data was recorded for injections.89 patients went forward for surgical excision of the IPF. The surgical approach for excision was either dorsal (60.7%) or plantar (39.3%). All plantar incisions (transverse and linear) were analysed as a group for comparison against the dorsal approach. Using an independent t-test, there was no significant difference for dorsal or plantar approach or location of IPF across the three MOxFQ domains and PSQ10.Using a Pearson product moment correlation coefficient there was a moderately strong correlation between the PSQ10 and the MOxFQ domains (n=89, Walking and Standing: r=0.48, p<0.01; Pain: r=0.42, p<0.01; Social Interaction: r=0.40, p<0.01). Where increases in MOxFQ outcome score (amount of improvement) produces higher PSQ10 scores (greater patient satisfaction).ConclusionsMore audit data is required to assess the effectiveness of steroid and / or alcohol injections. Recommendation for practice is based on literature review. The surgical outcomes would suggest that the excision of IPF is an appropriate and effective technique and the surgical approach or location of pathology will not affect the clinical outcomes. A new care pathway for the management of IPF (Morton’s Neuroma) will be employed in practice and

scholarly journals A systematic review on conservative and non-operative treatment options for Osgood-Schlatter disease

2020 ◽  
Author(s):  
Cornelia Neuhaus ◽  
Christian Appenzeller-Herzog ◽  
Oliver Faude
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Treatment Options ◽  
Grey Literature ◽  
Case Series ◽  
Outcome Data ◽  
Control Group ◽  
Retrospective Case ◽  
Review Articles ◽  
Knee Pathology

Background: Osgood-Schlatter disease (OSD) is a sport- and growth-associated knee pathology with painful osteochondrosis around the tibial tuberosity. Up to 10% of adolescents are affected by OSD. Treatment is primarily conservative or non-operative and includes injections, ice, braces, casts, tape and/or physiotherapy. However, treatment outcomes are often insufficiently described and there is lack of evidence for current best practice.Objective: The aims of this systematic review are to comprehensively identify conservative or non-operative treatment options for OSD, to compare their effectiveness in selected outcomes, and to describe potential research gaps. and to describe potential research gaps.Methods: This systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. CENTRAL, CINAHL, EMBASE and MEDLINE via Ovid, and PEDro were searched through to January 6, 2020. In addition, ongoing and unpublished clinical studies, dissertations, and other grey literature on OSD were retrieved. We included prospective, retrospective, case control, randomised, and non-randomised studies reporting on the effectiveness of any conservative or non-operative treatment of 6- to 28-year-old OSD patients. Studies written in English, German, or French were included. The quality of the included studies was assessed using the PEDro scale and extracted outcome data were narratively synthesized. In addition, we also systematically retrieved review articles for extraction of treatment recommendations.Results: Of 767 identified studies, thirteen were included: two randomised controlled trials (RCTs), two prospective and eight retrospective observational studies, and one case series. Eight studies had no control group. The included studies were published from 1948 to 2019 and included 747 patients (563 male, 119 female, 65 sex not reported) with 937 affected knees. The study quality was poor to moderate. The two included RCTs examined the effectiveness of surplus dextrose-injection in OSD patients treated with local anaesthetics injection and came to opposite conclusions. Other than that, inter-study heterogeneity prohibited any descriptive cumulative analyses. Among the 15 review articles, the most prevalent treatment recommendations were activity modification (15/15), quadriceps and hamstring stretching (13/15), medication (11/15), ice (11/15), strengthening of the quadriceps (9/15), and knee straps or brace (8/15).Conclusion: Conflicting evidence exists to support the use of dextrose injections. Certain therapeutic approaches, such as stretching, seem to work, but no RCT comparing specific exercises with sham or usual care treatment exists. Carefully controlled studies on well- described treatment approaches are needed to establish which conservative or non-operative treatment options are most effective for patients with OSD.

Results of operative treatment of double Morton’s neuroma in the same foot

2009 ◽  
Vol 14 (5) ◽  
pp. 574-578 ◽  
Author(s):  
Kyung Tai Lee ◽  
Young Koo Lee ◽  
Ki Won Young ◽  
Hak Jun Kim ◽  
Shin Yi Park
Keyword(s):  
Operative Treatment ◽  
Morton’S Neuroma ◽  
Morton's Neuroma

scholarly journals Is it time to rethink the diagnosis of Morton’s Neuroma?

2019 ◽  
Vol 4 (11) ◽  
Keyword(s):  
Treatment Options ◽  
Correct Diagnosis ◽  
Delayed Diagnosis ◽  
Morton’S Neuroma ◽  
Retrospective Case ◽  
Multiple Treatment ◽  
Morton's Neuroma ◽  
Receive Treatment ◽  
The Right ◽  
Clinical Records

There is currently little consensus on the definition and correct diagnosis of Morton’s Neuroma. The literature offers multiple treatment options. Presently, a major concern is incorrectly or over-diagnosing of the condition. The objective of this paper is to examine the likelihood of an incorrect diagnosis of patients who receive treatment for Morton’s Neuroma and compare to the rates of diagnosis and treatments demonstrated in the academic literature. A retrospective case cohort review was conducted examining patient clinical records over a five-year period from a single clinical practice. The data collected pertained to who and how the diagnosis of Morton’s Neuroma was made, the treatments performed and their outcomes. Our review included 30 patients (mostly women) presenting on the right foot. A diagnosis of Morton’s Neuroma was suggested by a General Practitioner in majority of the cases, followed by Radiologists, Orthopaedic Surgeons and Vascular Surgeons respectively. The chief concern was the frequent inaccurate diagnosis of Morton’s Neuroma in this patient cohort. The uncertainties surrounding this condition result in delayed diagnosis and treatment, unnecessary expenditure of health care funds, and deleteriously affects quality of life in patients.

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