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intermetatarsal neuroma

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https://www.readbyqxmd.com/read/29778841/sclerosing-alcohol-injections-for-the-management-of-intermetatarsal-neuromas-a-systematic-review
#1
REVIEW
Derek Santos, Graeme Morrison, Andrea Coda
An intermetatarsal neuroma is a plantar digital neuritis causing metatarsalgia of the affected inter-metatarsal space. At present the evidence to support the management of the condition is poor with only some quality evidence supporting the short-term management of intermetatarsal neuromas using steroid injections. Some authors have supported the use of alcohol sclerosing intra-lesional injections to treat intermetatarsal neuromas. Following a search of the evidence 11 articles were identified. The systematic review found that alcohol injections appear to be safe although some papers report a short-term side effect of a flogistic reaction and there are variances in the alcohol concentration used and guiding verses not guiding the injection using ultrasound imaging...
December 28, 2017: Foot
https://www.readbyqxmd.com/read/29470159/central-metatarsalgia-and-walking-on-pebbles-beyond-morton-neuroma
#2
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
https://www.readbyqxmd.com/read/29354403/endoscopic-interdigital-neurectomy-of-the-foot
#3
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
https://www.readbyqxmd.com/read/29153007/ultrasound-guided-hyaluronic-acid-injection-for-the-management-of-morton-s-neuroma
#4
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
https://www.readbyqxmd.com/read/29047294/deep-transverse-metatarsal-ligament-transection-in-morton-s-neuroma-excision-a-cadaveric-study-examining-effects-on-metatarsal-alignment
#5
Nathaniel Preston, Daniel Peterson, Jamey Allen, Jill S Kawalec, Jeffrey Whitaker
BACKGROUND: In the dorsal incisional approach for Morton's neuroma, it is required to transect the deep transverse metatarsal ligament (DTML) that lies in the interspace between the third and fourth metatarsal heads. The purpose of this study was to evaluate the relationship between transection of the DTML in the third intermetatarsal space and the metatarsal alignment. METHODS: Nine human cadaveric lower extremity limbs were used for this study. Each limb was mounted to the MTS 858 Mini Bionix biomechanical test system and loaded to 120% of the donor's documented body weight at a rate of 15 lbf/s, in order to simulate peak weightbearing ground reactive forces on the forefoot...
October 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28956110/ultrasound-guided-percutaneous-radiofrequency-for-the-treatment-of-morton-s-neuroma
#6
Salvatore Masala, Alessandro Cuzzolino, Marco Morini, Mario Raguso, Roberto Fiori
PURPOSE: Morton's neuroma (MN) is a leading cause of disability. The purpose of this study was to investigate the effectiveness of radiofrequency (RF) in patients with chronic pain refractory to conservative therapies. METHODS: Between September 2012 and December 2016, RF was performed on 52 patients. A sterile RF needle probe (22G, 5-cm needle with 10-mm electrode active tip) was inserted between the toes into the intermetatarsal space at the center of the lesion...
January 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28249977/the-role-of-the-width-of-the-forefoot-in-the-development-of-morton-s-neuroma
#7
Y H Park, S M Jeong, G W Choi, H J Kim
AIMS: Morton's neuroma is common condition of the forefoot, but its aetiology remains unclear. Our aim was to evaluate the relationship between the width of the forefoot and the development of a Morton's neuroma. PATIENTS AND METHODS: Between January 2013 and May 2016, a total of 84 consecutive patients (17 men, 67 women) with a unilateral Morton's neuroma were enrolled into the study. The involved and uninvolved feet of each patient were compared. A control group of patients with symptoms from the foot, but without a neuroma who were matched for age, gender, affected side, and web space location, were enrolled...
March 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28003923/interdigital-neuroma-in-the-second-intermetatarsal-space-associated-with-metatarsophalangeal-joint-instability
#8
Takumi Matsumoto, Song Ho Chang, Naohiro Izawa, Yohei Ohshiro, Sakae Tanaka
The entrapment theory is the most commonly accepted theory concerning the development of interdigital neuroma; it incriminates the deep transverse metatarsal ligament as the major causative factor of the condition. This report presents a patient with interdigital neuroma in the second intermetatarsal space, which was strongly suspected to be caused by the metatarsophalangeal joint instability due to plantar plate injury. Surgical intervention revealed that the neuroma was located more distally and dorsally than the deep transverse metatarsal ligament and was pinched between the adjacent metatarsal heads, suggesting the involvement of the metatarsophalangeal joint instability and chronic trauma as etiologies in this case...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27897032/ultrasound-evaluation-of-morton-neuroma-before-and-after-laser-therapy
#9
Lana H Gimber, David M Melville, Darin A Bocian, Elizabeth A Krupinski, Matthew P Del Guidice, Mihra S Taljanovic
OBJECTIVE: The objective of our study was to retrospectively assess for differences in imaging appearances of Morton neuromas before and after laser therapy using diagnostic ultrasound (US). MATERIALS AND METHODS: A retrospective review was performed to identify patients who underwent US imaging to evaluate for Morton neuroma during the study period (June 1, 2013-July 1, 2014); of the 42 patients identified, 21 underwent US evaluations before and after laser therapy...
February 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27837053/radiographic-analysis-of-feet-with-and-without-morton-s-neuroma
#10
Reza Naraghi, Alexandra Bremner, Linda Slack-Smith, Alan Bryant
BACKGROUND: The aim of this research was to investigate the association of various structural measurements of the forefoot with Morton's neuroma (MN). METHODS: Weightbearing anteroposterior and lateral foot radiographs of subjects attending the University of Western Australia (UWA) Podiatry Clinic and the first author's private practice were included in this study. A single assessor measured the following angles: lateral intermetatarsal angle (LIMA), intermetatarsal angle (IMA), hallux valgus angle (HVA), digital divergence between the second and third digits (DD23), digital divergence between the third and fourth digits (DD34) and relative metatarsal lengths of the first to fifth metatarsals (Met1-5), and the effect of MN size as measured by ultrasonograph on digital divergence...
March 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27562973/sonography-of-morton-neuromas-what-are-we-really-looking-at
#11
Stuart L Cohen, Theodore T Miller, Scott J Ellis, Matthew M Roberts, Edward F DiCarlo
OBJECTIVES: To determine what accounts for the sonographic appearance of a Morton neuroma by correlating preoperative sonograms with the sonographic appearance of the resected surgical specimen, the surgical findings, and the pathologic examination. METHODS: Ten Morton neuromas that had preoperative sonograms underwent postoperative specimen sonography and histologic evaluation. The appearance and size of the neuromas were compared between the preoperative and postoperative specimen images and were compared to the surgical and pathologic appearances...
October 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27284515/endoscopic-intermetatarsal-ligament-decompression
#12
Tun Hing Lui
Morton neuroma is an entrapment of the intermetatarsal nerve by the deep intermetatarsal ligament. It is usually treated conservatively. Surgery is considered if there is recalcitrant pain that is resistant to conservative treatment. The surgical options include resection of the neuroma or decompression of the involved nerve. Decompression of the nerve by release of the intermetatarsal ligament can be performed by either an open or minimally invasive approach. We describe 2-portal endoscopic decompression of the intermetatarsal nerve...
December 2015: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27013414/management-of-painful-recurrent-intermetatarsal-neuroma-using-processed-porcine-extracellular-matrix-material-a-case-report
#13
REVIEW
Robert G Parker, Orlando Merced-O'Neil
Painful recurrent stump neuroma presents a common clinical problem following the transection of a nerve after initial interdigital neuroma excision but there is no gold standard of treatment. A patient presented with pain symptoms consistent with recurrent intermetatarsal stump neuroma after undergoing previous surgery to excise a Hauser neuroma. The recurrent stump neuroma was excised and the resulting nerve was capped and implantation into intrinsic muscle. Postoperatively, the patient experienced a complete resolution of pain and return of normal function...
April 2016: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/26964696/diagnostic-value-of-elastography-in-the-diagnosis-of-intermetatarsal-neuroma
#14
Tugrul Ormeci, Olcay Güler, Melih Malkoc, Mert Keskinbora, Fatma Zeynep Güngören, Mahir Mahirogulları
The objective of the present study was to characterize the ultrasound and elastographic properties of intermetatarsal neuroma (interdigital neuroma) and their contribution to diagnosis. Eighteen patients with metatarsalgia, who had presented to an orthopedic clinic from April 2013 to February 2015, were diagnosed with 25 intermetatarsal neuromas (11 unilateral [61.11%], 7 bilateral [38.89%]). These patients underwent evaluation with ultrasonography and simultaneous ultrasound strain elastography to assess the elastographic properties of the tissues in the intermetatarsal space...
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/26963851/a-randomized-double-blind-placebo-controlled-trial-of-injected-capsaicin-for-pain-in-morton-s-neuroma
#15
RANDOMIZED CONTROLLED TRIAL
Claudia M Campbell, Eric Diamond, William K Schmidt, Margaret Kelly, Robert Allen, William Houghton, Kerrie L Brady, James N Campbell
Intermetatarsal neuroma or Morton's neuroma is a painful condition of the foot resulting from an entrapment of the common digital nerve typically in the third intermetatarsal space. The pain can be severe and especially problematic with walking. Treatment options are limited and surgery may lead to permanent numbness in the toes. Capsaicin, the pungent ingredient of hot peppers, produces analgesia by inducing retraction of nociceptive afferents from the area of innervation and is effective in treating certain neuropathic pain disorders...
June 2016: Pain
https://www.readbyqxmd.com/read/26887801/evaluation-of-lesser-metatarsophalangeal-joint-plantar-plate-tears-with-contrast-enhanced-and-fat-suppressed-mri
#16
Vanessa Dinoá, Felipe von Ranke, Flavia Costa, Edson Marchiori
OBJECTIVE: To present findings of plantar plate (PP) lesions from MRI with administration of gadolinium and to differentiate PP lesions from others causes of metatarsalgia. MATERIALS AND METHODS: Two musculoskeletal radiologists reviewed 249 contrast-enhanced forefoot MRI scans from patients with metatarsalgia between June 2012 and June 2013. Evaluations focused on hyper-vascularized/fibrous tissue and other findings associated with PP tears. RESULTS: Fifty-nine patients had PP tears, 59 % were female...
May 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/26883232/percutaneous-alcohol-injection-under-sonographic-guidance-in-morton-s-neuroma-follow-up-in-220-treated-lesions
#17
Luciano Perini, Claudia Perini, Matteo Tagliapietra, Davide Varotto, Andrea Valcarenghi, Andrea Postorino, Antonio Volpe
PURPOSE: To evaluate the efficacy and safety of percutaneous treatment of Civinini-Morton's syndrome due to solitary Morton's neuroma and analyze the effect of clinico-demographic factors on outcome. MATERIALS AND METHODS: Alcohol injection was performed under sonographic guidance in 220 consecutive patients. Pain intensity using a numerical rating scale (NRS), pain features, limitation of everyday activities and comorbidity with other forefoot conditions were evaluated at presentation...
July 2016: La Radiologia Medica
https://www.readbyqxmd.com/read/26719604/minimally-invasive-endoscopic-decompression-of-the-intermatatarsal-nerve-for-morton-s-neuroma
#18
Mitsuaki Kubota, Ryuichi Ohno, Muneaki Ishijima, Ryo Hanyu, Kensuke Sakai, Yu Sugawara, Hironori Ochi, Humihiro Mukasa, Kazuo Kaneko
BACKGROUND: We presented case reports of endoscopic decompression for a Morton intermetatarsal neuroma. METHODS: Three patients underwent surgery using an instrument designed to release the transverse carpal ligament for carpal tunnel syndrome. Each patient was 61, 56 and 24 years old. The mean follow up period was 1.5 years. RESULTS: All patients experienced reduced pain postoperatively. The postoperative scar was very small (only 1 cm). There is no loss of sensation, no hematoma and no infection...
October 2015: Journal of Orthopaedics
https://www.readbyqxmd.com/read/26344448/transection-of-the-deep-metatarsal-transverse-ligament-in-morton-s-neuroma-surgery-does-not-increase-risk-of-splayfoot-development
#19
Maximilian Kasparek, Wolfgang Schneider
PURPOSE: Although operative excision is regarded as the treatment of choice in Morton's neuroma, it remains unclear whether transection of deep transverse metatarsal ligament (DTML) is a risk for metatarsal splaying and whether simultaneous surgery in adjacent intermetatarsal spaces is a risk for osteonecrosis of the adjacent metatarsals. METHODS: Fifty-seven feet in 47 patients had excision of a Morton's neuroma, with a mean follow-up of 15.3 years. Feet were categorised depending upon whether the DTML was or was not divided...
May 2016: International Orthopaedics
https://www.readbyqxmd.com/read/25945935/ultrasound-guided-pulsed-radio-frequency-treatment-in-morton-s-neuroma
#20
RANDOMIZED CONTROLLED TRIAL
Suleyman Deniz, Tarik Purtuloglu, Sukru Tekindur, Kadir Hakan Cansız, Memduh Yetim, Oguz Kılıckaya, Serkan Senkal, Serkan Bilgic, Abdulkadir Atim, Ercan Kurt
BACKGROUND: Morton's neuroma is a perineural fibrosis of an intermetatarsal plantar nerve. Burning, numbness, paresthesia, and tingling down the interspaces of involved toes may also be experienced. Taking into account all of this information, we designed a prospective open-label study to evaluate the efficacy of pulsed radio frequency on Morton's neuroma. METHODS: Twenty patients with Morton's neuroma were experiencing symptomatic neuroma pain in the foot not relieved by routine conservative treatment...
July 2015: Journal of the American Podiatric Medical Association
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