Improved Injection Technique of Ethanol for Morton's Neuroma

التفاصيل البيبلوغرافية
العنوان: Improved Injection Technique of Ethanol for Morton's Neuroma
المؤلفون: Isabella Malaj, Harald Lothaller, Elena Manuela Samaila, Bruno Magnan, Christof Pabinger
المصدر: Footankle international. 41(5)
سنة النشر: 2020
مصطلحات موضوعية: Metatarsalgia, Adult, Male, medicine.medical_specialty, Sclerosant injection, Morton Neuroma, Morton's neuroma, Injections, Intralesional, metatarsalgia, Alcohol ablation, Morton’s neuroma, medicine, Humans, Orthopedics and Sports Medicine, Prospective Studies, Aged, Ethanol, business.industry, alcohol ablation, sclerosant injection, Middle Aged, medicine.disease, Neuroma, Surgery, interdigital neuroma, Forefoot pain, Fluoroscopy, Female, business, Interdigital neuroma
الوصف: Background:Morton’s neuroma is a common cause of forefoot pain. Various conservative methods (injections of various pharmacologic agents) have been published with an outcome of 6%-75% success rate (free of pain in daily life) per injection. The aim of the present study was to assess the outcome of an improved localization technique, a higher dosage, and a higher percentage of ethanol.Methods:Using fluoroscopic and electroneurographic guidance, 2.5 mL of 70% ethanol were injected into 33 feet with a magnetic resonance imaging (MRI)–verified neuroma. We evaluated patients at up to 5-year follow-up.Results:A “success rate” of more than 82% per single injection (defined as free of pain in daily life) was achieved and no recurrence was seen over 5 years. All scores (visual analog scale; Short Form–36 subscales, American Orthopaedic Foot & Ankle Society ankle-hindfoot score) showed significant improvement ( P < .0001). Mean 1.2 injections were necessary. No significant side effects were seen. However, some mild pain persisted in some patients who participated in sports.Conclusion:The injection of 2.5 mL of 70% ethanol under fluoroscopic and electroneurographic guidance was a safe method for the treatment of MRI-verified Morton’s neuromas. Combining the effect of a higher percentage of alcohol and a higher dosage and an improved localization technique resulted in a high rate of patients without pain.Level of Evidence:Level IV, cases series, prospective.
تدمد: 1944-7876
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6169e7d1eaff1eaf679f04a20ecd5b88
https://pubmed.ncbi.nlm.nih.gov/32013586
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....6169e7d1eaff1eaf679f04a20ecd5b88
قاعدة البيانات: OpenAIRE