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Morton’s neuroma

Andrea Angelini, Roberto Bevoni, Carlo Biz, Maria Chiara Cerchiaro, Mauro Girolami, Pietro Ruggieri
Schwannoma is a soft tissue tumor that rarely presents in the foot. Patients are usually asymptomatic, but in some cases symptoms typically result from the mass effect and direct involvement of the nerve and surrounding tissue. We report on four consecutive cases. The first patient was a 57-years-old female that referred symptoms similar to the Morton's neuroma with a mass arising from the medial plantar nerve. The second patient was treated for a schwannoma in the plantar area. The third case was a female with a schwannoma arising from the sural nerve and the fourth patient had a tumor arising from the medial plantar nerve...
January 10, 2019: Acta Bio-medica: Atenei Parmensis
Young Hwan Park, Won Seok Choi, Gi Won Choi, Hak Jun Kim
OBJECTIVES: Sonography is often used for analysis of Morton neuromas, but the measurement reliability is unknown. The aim of this study was to determine the intra- and interobserver reliability and precision of sonographic measurement of Morton neuromas. METHODS: Three observers with different levels of sonography experience (observer A, expert; observer B, intermediate; observer C, beginner) performed repeated measurements of the size of Morton's neuroma in 20 patients...
January 7, 2019: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Jae Hwang Song, Chan Kang, Deuk Soo Hwang, Dong Hun Kang, Yong Hwan Kim
BACKGROUND: The purpose of this study was to investigate and compare the clinical outcomes of dorsal suspension with those of neurectomy for the treatment of Morton's neuroma. METHODS: We conducted a retrospective study of dorsal suspension and neurectomy group. The dorsal suspension was performed by dorsal transposition of neuroma over the dorsal transverse ligament after neurolysis. The visual analog scale (VAS), the Foot and Ankle Ability Measure (FAAM), postoperative satisfaction, and complications were evaluated...
October 5, 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Fernando Ruiz Santiago, Pablo Tomás Muñoz, Patel Pryest, Alberto Martinez Martínez, Nicolás Prados Olleta
Among the many causes of forefoot pain, Morton's neuroma (MN) is often suspected, particularly in women, due to its high incidence. However, there remain controversies about its relationship with symptomatology and which diagnostic and treatment choices to choose. This article mainly focuses on the role of the various imaging methods and their abilities to support an accurate diagnosis of MN, ruling out other causes of forefoot pain, and as a way of providing targeted imaging-guided therapy for patients with MN...
September 28, 2018: World Journal of Radiology
Young Hwan Park, Tae Jin Kim, Gi Won Choi, Hak Jun Kim
OBJECTIVES: This study aims to evaluate the clinical importance of intermetatarsal distance, size of neuroma, and proportion of neuroma in the intermetatarsal space in examinations of Morton neuroma using ultrasonography. METHODS: Clinical prognosis was observed prospectively after corticosteroid injections in 136 patients with Morton neuroma, and the results were compared with ultrasonographic parameters of intermetatarsal distance, size of neuroma, and proportion of neuroma in the intermetatarsal space...
September 23, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Zachariah Pinter, Christopher Odom, Andrew McGee, Kyle Paul, Samuel Huntley, John L Johnson, Ashish Shah
BACKGROUND: When using a dorsal approach for Morton's neuroma excision, the most common complication is recurrent Morton's neuroma. The present cadaveric study demonstrates how far proximally the nerve is resected during a dorsal approach and examines both the laminar spreader and Gelpiretractor to determine which instrument facilitates maximal proximal resection of the nerve. METHODS: This study involved 12 fresh-frozen cadaver specimens, each of which underwent a dorsal approach to the interdigital nerve with proximal resection...
August 15, 2018: Foot & Ankle Specialist
Fernando Ruiz Santiago, Nicolás Prados Olleta, Pablo Tomás Muñoz, Luis Guzmán Álvarez, Alberto Martínez Martínez
OBJECTIVE: The aim of this work is to compare the effectiveness of blind and ultrasound-guided injection for Morton's neuroma (MN) to determine which is more appropriate as the initial procedure in conservative treatment. METHODS: This is an evaluator-blinded randomised trial. Of the 56 included patients, 27 were assigned to the blind group (A) and 29 to the ultrasound-guided group (B). Injection includes 1 ml of 2% mepivacaine and 40 mg of triamcinolone in each web space with MN...
July 31, 2018: European Radiology
Fatemeh Razaghi, Eildar Abyar, Carly A Cignetti, Jeffery A Jones, Eva Lehtonen, John L Johnson, Matthew Anderson, Alan Hsu, Kyle D Paul, Ashish Shah
Non-infectious soft tissue lesions of the foot and ankle are relatively rare clinically. These include benign and malignant neoplasms, as well as non-neoplastic or pseudotumoral lesions such as ganglionic, synovial and epidermoid cysts, intermetatarsal and adventitious bursitis, inflammatory lesions like gouty tophi and rheumatoid nodules, Morton's neuroma, and granuloma annulare. A 48-year-old male with a history of medically treated tophaceous gout presented with left foot neuropathic pain and paresthesia, in the setting of a well-circumscribed soft tissue lesion of the second intermetatarsal space, suspected to be a Morton's neuroma...
May 14, 2018: Curēus
Min Cheol Chang
BACKGROUND: Recently, clinicians have been applying pulsed radiofrequency (PRF) stimulation on various peripheral nerves to manage patients' peripheral neuropathic pain. OBJECTIVES: To review the literature on the use and efficacy of PRF for controlling peripheral neuropathic pain. STUDY DESIGN: This is a narrative review of relevant articles on the effectiveness of PRF for peripheral neuropathic pain. METHODS: A PubMed search was conducted for papers published from January 1, 1980 to August 31, 2017 that used PRF to treat peripheral neuropathic pain...
May 2018: Pain Physician
Paolo Lorenzon, Carlo Rettore
Although many treatment modalities are available for Morton's neuroma, the injection of the neuroma with alcohol has gained popularity. However, recently, some investigators have observed a progressive deterioration in pain scores for patients initially pain free after the treatment. The purpose of the present retrospective comparative study was to determine whether mechanical metatarsalgia is related to symptom recurrence. We included 104 consecutive cases of ultrasound-guided alcohol injection for Morton's neuroma in 92 patients...
September 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Akash Ganguly, Joanne Warner, Hifz Aniq
OBJECTIVE: Central metatarsalgia relates to abnormalities of the second, third, and fourth metatarsals and their respective metatarsophalangeal joints. A variety of disorders present with central forefoot pain; they range from traumatic lesions (acute or chronic repetitive), inflammatory and infective disorders, nonneoplastic soft-tissue lesions, and benign tumors to malignant lesions. Patients often present with symptoms of localized pain in the forefoot that worsens on weight bearing (walking or running), which can be sharp or dull and often is perceived as a lump felt inside or underneath the foot and described as walking on a marble or pebbles...
April 2018: AJR. American Journal of Roentgenology
Silvia Valisena, Gianfranco John Petri, Andrea Ferrero
BACKGROUND: The treatment of Morton's neuroma (MN) can be operative, conservative and infiltrative. Our aim was the evaluation of evidence on outcomes with different types of conservative, infiltrative and surgical treatment in patients affected by primary MN. METHODS: The bibliographic search was conducted in MEDLINE, Cochrane Library, DARE. Only studies in English were collected. The last search was in August 2015. Case series and randomized controlled trials (RCTs) assessing patients' satisfaction or pain improvement at an average follow-up of at least 6 months after treatment of primary MN were included...
August 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Katherine M Edenfield, Charlie Michaudet, Guy W Nicolette, Peter J Carek
The midfoot and forefoot are the regions of the foot distal to the talus and calcaneus and are critical to weight bearing and movement. They help support the arch of the foot, provide shock absorption, and convert vertically oriented forces into horizontal forward and propulsive movement. A spectrum of acute, subacute, and chronic conditions in these regions can cause pain and decreased function. A thorough history and physical examination should include foot and leg biomechanics, alignment, and posture in addition to palpation of painful areas...
February 2018: FP Essentials
Tun Hing Lui
Morton's neuroma is a compressive neuropathy resulting in perineural fibrosis rather than a neuroma of the plantar digital nerve. Surgical treatment is indicated for patients with a clear diagnosis of Morton's neuroma and no improvement with nonsurgical treatment. The surgical options include isolated intermetatarsal ligament division, isolated interdigital nerve excision, and interdigital nerve excision with intermetatarsal ligament division, with or without submuscular transposition. This can be performed via dorsal or plantar approach...
August 2017: Arthroscopy Techniques
Ashish B Shah, Breann K Tisano, Osama Elattar, Jackson Rucker Staggers, Sameer Naranje
Introduction: Hajdu-Cheney syndrome (HCS) is a rare autosomal dominant disease characterized by acroosteolysis, wormian skull bones with persistent skull sutures, premature loss of teeth, micrognathia, short stature, hypermobility of the joints, neurologic manifestations such as basilar invagination with subsequent paresthesia, hearing loss, and speech alterations, and osteoporosis with tendency to pathologic fractures of long bones and vertebrae as well as painful hands and feet. Very few cases have been earlier reported in the literature...
September 2017: Journal of Orthopaedic Case Reports
Young Hwan Park, Ja Woon Lee, Gi Won Choi, Hak Jun Kim
BACKGROUND: Understanding the risk factors that predict the prognosis of Morton's neuroma after corticosteroid injection would help clinicians determine the appropriate treatment protocol. However, the cut-off values for the risk factors are unknown. The aim of this study was to identify the risk factors and cut-off values that predict failure of corticosteroid injection in treatment of Morton's neuroma. METHOD: Among 201 patients who had corticosteroid injection for Morton's neuroma, 40 underwent further treatment after injections...
February 2018: International Orthopaedics
F Sancho-Barroso, J Strassburger-Weidmann, V Castillo-Anaya
BACKGROUND: The purpose of this paper is to assess pain, function and complications after decompression of Mortons neuroma using a minimally invasive dorsal approach. METHOD AND RESULTS: 16 patients who underwent 19 decompressions were followed-up for 18 months. Pain was assessed with the visual analog scale (VAS), and function was assessed with the American Orthopedic Foot and Ankle Society (AOFAS) scale. Data was analyzed with the Student t test for related samples, which yielded a p value 0...
May 2017: Acta Ortopédica Mexicana
Joonho Lee, Jeongyo Kim, Myoungjin Lee, Intak Chu, Sungjae Lee, Heuichul Gwak
Background: Morton's neuroma is a common cause of metatarsalgia and many treatments had been described in literature. However, there have been only a few reports that treat the neuroma with an osteotomy on the proximal, not distal portion of the metatarsal bone using a plate. This study describes the clinical outcome of sliding osteotomy on the proximal metatarsal bone for the treatment of Morton's neuroma. Materials and Methods: Sixty five consecutive patients (85 feet) who underwent surgery for Morton's neuroma between November 2010 and February 2013 were identified from hospital records to include in this retrospective study...
November 2017: Indian Journal of Orthopaedics
Louis H Poppler, Rajiv P Parikh, Miles J Bichanich, Kelsey Rebehn, Carrie R Bettlach, Susan E Mackinnon, Amy M Moore
A consensus on the optimal treatment of painful neuromas does not exist. Our objective was to identify available data and to examine the role of surgical technique on outcomes following surgical management of painful neuromas. In accordance with the PRISMA guidelines, we performed a comprehensive literature search to identify studies measuring the efficacy of the surgical treatment of painful neuromas in the extremities (excluding Morton's neuroma and compression neuropathies). Surgical treatments were categorized as excision-only, excision and transposition, excision and cap, excision and repair, or neurolysis and coverage...
February 2018: Pain
Kang Lee, Il-Yeong Hwang, Chang Hyun Ryu, Jae Woo Lee, Seung Woo Kang
BACKGROUND: Morton's neuroma is one of the common causes of forefoot pain. In the present study, hyaluronic acid injection was performed on patients to determine the efficacy and adverse effects of hyaluronic acid in management of Morton's neuroma. METHODS: Eighty-three patients with Morton's neuroma in their third intermetatarsal space with definite Mulder's click were included in the study. Those with severe forefoot deformities such as forefoot cavus or hallux valgus on plain X-rays were excluded...
February 2018: Foot & Ankle International
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