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Alcohol Injection for Mortons Neuroma

Discussion in 'General Issues and Discussion Forum' started by NewsBot, May 18, 2013.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Alcohol Injection for Morton’s Neuroma A Five-Year Follow-Up
    Sabahat Gurdezi, Thomas White, Palanisamy Ramesh
    Foot & Ankle International May 13,
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Re: Alcohol Injection for Morton’s Neuroma

    Effects of Alcohol Injection in Rat Sciatic Nerve as a Model for Morton’s Neuroma Treatment
    Mathew J. Mazoch, Gulraiz A. Cheema, Larry J. Suva, Ruth L. Thomas
    Foot & Ankle International August 5, 2014
     
  4. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Re: Alcohol Injection for Morton’s Neuroma

    Ultrasound-Guided Alcohol Injection for Morton’s Neuroma
    Cecilia Pasquali, et al
    Foot & Ankle International November 3, 2014
     
  5. Mart

    Mart Well-Known Member

    Re: Alcohol Injection for Morton’s Neuroma

    I think that this is an important cautionary paper;

    it concluded

    "Injection therapy is sometimes seen as a less traumatic option, but one-third of our patients described either immense pain at the time of injection (despite the use of local anesthetic), significant bruising, prolonged pain lasting weeks, or paresthesia in adjacent toes. Patients should be well informed of such complications of this less invasive intervention.

    Our study is the only available literature on long-term follow-up for alcohol injections.

    Although operative treatment carries morbidity, current evidence would suggest that it continues to be the only definitive treatment of interdigital neuroma unresponsive to conservative care. Our investigation includes some retrospective data that may lead to bias in the results, and a randomized controlled trial comparing surgery to other injectable treatments with medium- to long-term follow-up is required to answer the long-standing debate on the best treatment for Morton’s neuroma."

    One observation I have is that at short term follow up in my clinic there seems to be an association between size of lesion and response to all conservative modalities; this seems intuitively likely.

    Although this study was retrospective all injections were done under US guidance which increases increases its value because we can infer that needle tip was were intended. I think that it would be interesting to know if there was any hint of association of outcome with lesion size but this was not reported.

    I believe that measuring lesion size US may be able to provide predictive value for outcome of conservative approach and therefore provided better selection for treatment approach.

    I believe that there remains a basic methodological issue to study that idea; determining a valid way to determine lesion size sonographically - anyone else thinking this way or have any comments on that idea?

    Cheers

    Martin

    Foot and Ankle Clinic
    1365 Grant Ave.
    Winnipeg Manitoba R3M 1Z8
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  6. Ian Reilly

    Ian Reilly Active Member

    Re: Alcohol Injection for Morton’s Neuroma

    looking at this just now mart - doing a lecture at SoCaP conf next week on MN ... but i think you have a point about size.... > 6mm... but of course some papers say it isn't an issue... i think it IS!

    ATB

    Ian
     
  7. Mart

    Mart Well-Known Member

    Re: Alcohol Injection for Morton’s Neuroma

    Hi Ian

    The 6mm in my experience seems close - the difficulty is validating reproducible measurement to properly test that idea. Also there is possibly of other important variables which might make that measurement lack useful predictive value. This might include gap at metatarsal heads and stiffness and flow behavior of plantar fibro-fatty pad.

    would love to catch up via skype when you have a moment or a hundred:drinks

    Cheers

    Martin

    Foot and Ankle Clinic
    1365 Grant Ave.
    Winnipeg Manitoba R3M 1Z8
    phone [204] 837 FOOT (3668)
    fax [204] 774 9918
    www.winnipegfootclinic.com
     
  8. Ian Reilly

    Ian Reilly Active Member

    Re: Alcohol Injection for Morton’s Neuroma

    let me do this ppt first. I always feel DUMB after talking to you!! Gotta revise first... lol
     
  9. Mart

    Mart Well-Known Member

    Re: Alcohol Injection for Morton’s Neuroma

    Damm that means I need to improve my people skills - I am working on that. :pigs:
     
  10. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Percutaneous alcohol injection under sonographic guidance in Morton's neuroma: follow-up in 220 treated lesions.
    Perini L et al
    Radiol Med. 2016 Feb 16
     
  11. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Sclerosing alcohol injections for the management of intermetatarsal neuromas: a systematic review
    Derek Santos et al
    The Foot; 28 December 2017
     
  12. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Mechanical Metatarsalgia as a Risk Factor for Relapse of Morton's Neuroma After Ultrasound-Guided Alcohol Injection
    Paolo Lorenzon, MD et al
    JFAS: Article in Press
     
  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
  14. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Short term comparison between blind and ultrasound guided injection in morton neuroma
    Fernando Ruiz SantiagoNicolás Prados OlletaPablo Tomás MuñozLuis Guzmán ÁlvarezAlberto Martínez Martínez
    European Radiology: 31 July 2018
     
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