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  1 / 22 MEDLINE  
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Fotocopia
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PMID:28249977
Autor:Park YH; Jeong SM; Choi GW; Kim HJ
Dirección:Korea University Guro Hospital, Department of Orthopaedic Surgery, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Korea.
Título:The role of the width of the forefoot in the development of Morton's neuroma.
Fuente:Bone Joint J; 99-B(3):365-368, 2017 Mar.
ISSN:2049-4408
País de publicación:England
Idioma:eng
Resumen: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. The first to fifth intermetatarsal distance, intermetatarsal angle and intermetatarsal distance of involved web space on standing radiographs were assessed. RESULTS: The inter- and intra-observer reliability was excellent. The three parameters did not differ significantly between the involved and uninvolved feet. Neither did they differ significantly between the patients and the controls. CONCLUSION: We conclude that there is no significant relationship between the width of the forefoot and the development of a Morton's neuroma. Cite this article: 2017;99-B:365-8.
Tipo de publicación:JOURNAL ARTICLE


  2 / 22 MEDLINE  
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PMID:27897032
Autor:Gimber LH; Melville DM; Bocian DA; Krupinski EA; Guidice MP; Taljanovic MS
Dirección:1 Department of Medical Imaging, University of Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724.
Título:Ultrasound Evaluation of Morton Neuroma Before and After Laser Therapy.
Fuente:AJR Am J Roentgenol; 208(2):380-385, 2017 Feb.
ISSN:1546-3141
País de publicación:United States
Idioma:eng
Resumen: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. US reports and images were reviewed and correlated with clinical history. The final study group consisted of 21 patients who had a total of 31 Morton neuromas evaluated using US after treatment. A retrospective review was then performed to characterize the appearances of these lesions before and after therapy followed by an analysis of variables. RESULTS: Retrospective US review of 31 pretreatment Morton neuromas showed fusiform, heterogeneously hypoechoic masses with well-defined borders in most cases and that pain was reported when transducer pressure was applied in 97% (30/31) of cases. After treatment, lesions showed ill-defined borders (23/31), and pain with application of transducer pressure was either significantly decreased or absent (29/31); these findings were concordant with the clinical findings. Both of these characteristics were statistically significant (p < 0.0001). In addition, more Morton neuromas occurred in the second intermetatarsal space than in the third intermetatarsal space (p < 0.0001). CONCLUSION: US may be used to identify posttreatment changes after laser therapy of Morton neuromas. Posttreatment changes include ill-defined borders and less pain or the absence of pain with the application of transducer pressure. These criteria may be applied in future clinical studies evaluating the efficacy of laser therapy for Morton neuroma.
Tipo de publicación:JOURNAL ARTICLE


  3 / 22 MEDLINE  
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PMID:27837053
Autor:Naraghi R; Bremner A; Slack-Smith L; Bryant A
Dirección:1 Podiatric Medicine Unit M422, School of Surgery, University of Western Australia, Crawley, Western Australia, Australia.
Título:Radiographic Analysis of Feet With and Without Morton's Neuroma.
Fuente:Foot Ankle Int; 38(3):310-317, 2017 Mar.
ISSN:1944-7876
País de publicación:United States
Idioma:eng
Resumen: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. Intratester reliability of all radiographic measurements was assessed on all radiographic measurements. The study included 101 subjects, of whom 69 were diagnosed with MN and 32 were control subjects without MN. The mean (± standard deviation) age of MN subjects was 52 (±15) years and for control subjects, 48 (±12) years. RESULTS: When comparing all feet, there were no significant differences in the LIMA, HVA, IMA, digital divergence angles and the relative metatarsal distances between subjects with MN and control subjects. No relationship between MN size and digital divergence was found in either foot, or in either neuroma location. CONCLUSION: We were unable to demonstrate any relationship in this study between radiographic metatarsal length and angular measurements in a symptomatic MN group compared to a control group. In addition, we did not find any correlation between the size of MN as measured from ultrasonographic images and radiographic evidence of digital divergence. LEVEL OF EVIDENCE: Level III, case control study.
Tipo de publicación:JOURNAL ARTICLE


  4 / 22 MEDLINE  
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Fotocopia
PMID:27980684
Autor:Naraghi R; Bremner A; Slack-Smith L; Bryant A
Dirección:School of Surgery, Podiatric Medicine Unit M422, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009 Australia.
Título:The relationship between foot posture index, ankle equinus, body mass index and intermetatarsal neuroma.
Fuente:J Foot Ankle Res; 9:46, 2016.
ISSN:1757-1146
País de publicación:England
Idioma:eng
Resumen:BACKGROUND: The main purpose of this study was to investigate the presence of an association between intermetatarsal neuroma and foot type, as measured by the Foot Posture Index. The study also examined whether there was a relationship between foot type and the interspace affected with intermetatarsal neuroma, and whether ankle equinus or body mass index had an effect. METHODS: In total, 100 participants were recruited from The University of Western Australia's Podiatry Clinic, 68 of whom were diagnosed with inter-metatarsal neuroma from 2009 to 2015. There were 32 control participants recruited from 2014 to 2015. The age of subjects was recorded, as were weight and height, which were used to calculate body mass index. The foot posture index and ankle dorsiflexion were measured using standard technique. Independent t-tests and Kruskal-Wallis tests were used to compare differences in foot posture index, body mass index and ankle dorsiflexion between the inter-metatarsal neuroma and control groups. Multivariable logistic regression was also used to model relationships for outcome. RESULTS: The 68 intermetatarsal neuroma subjects had a mean age of 52 years (range 20 to 74 years) and comprised of 56 females and 12 males. The 32 control subjects had a mean age of 49 years (range 24 to 67 years) with 26 females and six males. There were no significant differences between the control and the intermetatarsal neuroma groups with respect to the mean foot posture index scores of the left and right foot ( 0.21 and 0.87, respectively). Additionally no significant differences were detected between the affected intermetatarsal neuroma interspace and foot posture index ( = 0.27 and 0.47, respectively). There was no significant difference in mean body mass index between the intermetatarsal neuroma (26.9 ± 5.7) and control groups (26.5 ± 4.1) ( = 0.72). There was, however, a significant difference in mean ankle dorsiflexion between the intermetatarsal neuroma and control groups ( < 0.001 for both feet). Logistic regression models, adjusted for age, sex, foot posture index and body mass index estimated that the odds of having an intermetatarsal neuroma in the right foot increased by 61% (OR 1.61; 95% CI 1.32-1.96) with each one degree reduction of ankle dorsiflexion, and in the left foot by 43% (OR 1.43; 95% CI 1.22-1.69). CONCLUSION: No relationships were found between foot posture index and body mass index with intermetatarsal neuroma, or between foot posture index and the interspaces affected. However, a strong association was demonstrated between the presence of intermetatarsal neuroma and a restriction of ankle dorsiflexion.
Tipo de publicación:JOURNAL ARTICLE


  5 / 22 MEDLINE  
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Fotocopia
PMID:27694592
Autor:Bucknall V; Rutherford D; MacDonald D; Shalaby H; McKinley J; Breusch SJ
Dirección:Royal Infirmary of Edinburgh, Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, UK.
Título:Outcomes following excision of Morton's interdigital neuroma: a prospective study.
Fuente:Bone Joint J; 98-B(10):1376-1381, 2016 Oct.
ISSN:2049-4408
País de publicación:England
Idioma:eng
Resumen:AIMS: This is the first prospective study to report the pre- and post-operative patient reported outcomes and satisfaction scores following excision of interdigital Morton's neuroma. PATIENTS AND METHODS: Between May 2006 and April 2013, we prospectively studied 99 consecutive patients (111 feet) who were to undergo excision of a Morton's neuroma. There were 78 women and 21 men with a mean age at the time of surgery of 56 years (22 to 78). Patients completed the Manchester-Oxford Foot Questionnaire (MOXFQ), Short Form-12 (SF-12) and a supplementary patient satisfaction survey three months pre-operatively and six months post-operatively. RESULTS: Statistically significant differences were found between the mean pre- and post-operative MOXFQ and the physical component of the SF-12 scores (p = 0.00081 and p = 0.00092 respectively). Most patients reported their overall satisfaction as excellent (n = 49, 49.5%) or good (n = 29, 29.3%), but ten patients were dissatisfied, reporting poor (n = 8, 8.1%) or very poor (n = 2, 2.0%) results. Only 63 patients (63%) were pain-free at follow-up: in eight patients (8.1%), the MOXFQ score worsened. There was no statistically significant difference in outcome between surgery on single or multiple sites. However, the MOXFQ scores were significantly worse after revision surgery (p = 0.004). CONCLUSIONS: The patient-reported outcomes after resection of a symptomatic Morton's neuroma are acceptable but may not be as good as earlier studies suggest. Surgery at several sites can be undertaken safely but caution should be exercised when considering revision surgery. Cite this article: Bone Joint J 2016;98-B:1376-81.
Tipo de publicación:JOURNAL ARTICLE


  6 / 22 MEDLINE  
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PMID:27627563
Autor:Reichert P; Zimmer K; Witkowski J; Wnukiewicz W; Kulinski S; Gosk J
Dirección:Department and Clinic of Traumatology and Hand Surgery, Wroclaw Medical University, Poland.
Título:Long-Term Results of Neurectomy Through a Dorsal Approach in the Treatment of Morton's Neuroma.
Fuente:Adv Clin Exp Med; 25(2):295-302, 2016 Mar-Apr.
ISSN:1899-5276
País de publicación:Poland
Idioma:eng
Resumen:BACKGROUND: Morton's neuroma, a painful enlargement of the plantar digital nerve between the metatarsal heads, is a common cause of metatarsalgia. The etiology and treatment are still a controversial matter. OBJECTIVES: The objective of this study was to evaluate the long-term follow-up results of neurectomy through a dorsal approach and to identify prognostic factors that can affect the final outcome. MATERIAL AND METHODS: The study included 41 patients who were treated for Morton's neuroma. Their average age was 44 years (range: 25-69 years). The average follow-up time was 7.4 years (range: 5-12 years). Surgery was performed through a dorsal approach. The clinical evaluations, visual analog scale (VAS) scores and American Orthopedic Foot and Ankle Society (AOFAS) scores were assessed. RESULTS: The mean preoperative AOFAS score was 39.4 ± 7.84 and the mean postoperative AOFAS score was 83.4 ± 12.1. The mean preoperative VAS scale was 7.04 ± 1.4 and the mean postoperative VAS scale was 1.4 ± 0.8. There were 31 patients (76%) with very good results in the subjective and objective patient assessments; six (15%) had good results; one (2%) had satisfactory results and three (7%) had poor results. Statistically significant differences in the results between single and multiple neuromas were found, depending on the size of the neuromas and the duration of the symptoms. There were no statistically significant differences depending on the time between surgery and assessment, on steroid injections before operation or on the duration of preoperative conservative treatment. CONCLUSIONS: Despite the development of less invasive techniques and very good outcomes in a short period of time, long-term results have shown that neurectomy is still useful in the treatment of Morton's neuroma. The results of the study show that the outcome does not change during the postoperative follow-up period. The best results were achieved in the case of single neuromas larger than 3 mm that were resected within 12 months of the onset of symptoms.
Tipo de publicación:JOURNAL ARTICLE


  7 / 22 MEDLINE  
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PMID:27562973
Autor:Cohen SL; Miller TT; Ellis SJ; Roberts MM; DiCarlo EF
Dirección:Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY USA.
Título:Sonography of Morton Neuromas: What Are We Really Looking At?
Fuente:J Ultrasound Med; 35(10):2191-5, 2016 Oct.
ISSN:1550-9613
País de publicación:England
Idioma:eng
Resumen: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. RESULTS: Preoperative images showed a fibrillar echogenic nerve coursing into a heterogeneous hypoechoic mass measuring 14.3 mm in average length (range, 9.0-24.0 mm) that contained a round, mildly echogenic mass within it measuring 7.6 mm in average length (range, 4.5-12.0 mm). Surgically, the specimens showed scarred intermetatarsal bursas and tangled vessels surrounding the nerve. Specimen sonography showed echogenic focal enlargement of the nerve at the site of the neuroma, measuring 6.8 mm in average length (range, 3.5-11.0 mm). The size of the resected neuroma was smaller than the hypoechoic mass on the presurgical images (P < .001). Within the hypoechoic mass, the small echogenic focus showed no difference in size compared to the specimen (P = .40), but the shape of the echogenic specimen was fusiform, whereas the preoperative appearance was round. Histologically, the resected specimens showed sclerosis and mucoid degeneration of the nerve fascicles and fibrotic thickening of the perineurium. CONCLUSIONS: The hypoechoic heterogeneous mass that is referred to as a Morton neuroma sonographically is really a "neuroma-bursal complex" that is much larger than the actual neuroma itself.
Tipo de publicación:JOURNAL ARTICLE


  8 / 22 MEDLINE  
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PMID:27489971
Título:Erratum.
Fuente:J Am Podiatr Med Assoc; 106(4):298, 2016 Jul.
ISSN:1930-8264
País de publicación:United States
Idioma:eng
Tipo de publicación:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL


  9 / 22 MEDLINE  
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PMID:27301735
Autor:van Vendeloo SN; Ettema HB
Dirección:Department of Orthopaedic Surgery, Isala Hospital, Zwolle, The Netherlands. Electronic address: stefanvanvendeloo@gmail.com.
Título:Skin depigmentation along lymph vessels of the lower leg following local corticosteroid injection for interdigital neuroma.
Fuente:Foot Ankle Surg; 22(2):139-41, 2016 Jun.
ISSN:1460-9584
País de publicación:France
Idioma:eng
Resumen:Steroid injection is frequently used in the treatment of interdigital neuroma and has a high rate of success. We report the case of a patient who develops skin depigmentation at the injection site and linear streaks of depigmentation over the foot, the ankle and half way up to the knee after a steroid injection for interdigital neuroma. Minor disadvantages such as subcutaneous fat atrophy and depigmentation of the skin at the injection site are well known problems following steroid injection. Depigmentation of the skin with a lymphatic distribution in the foot after steroid injection for interdigital neuroma however, has not yet been reported before. This complication is a serious aesthetic problem and clinicians should be aware of this complication when treating patients with steroid injections for interdigital neuroma.
Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE
Nombre de substancia:0 (Glucocorticoids); F446C597KA (Triamcinolone Acetonide)


  10 / 22 MEDLINE  
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PMID:27269979
Autor:Shibata T; Yoshimura I; Kanazawa K; Hagio T; Minokawa S; Nagatomo M; Naito M
Título:Neurectomy for Bilateral Morton's Neuroma A Case Report of a Male Patient.
Fuente:J Am Podiatr Med Assoc; 106(3):229-34, 2016 May.
ISSN:1930-8264
País de publicación:United States
Idioma:eng
Resumen:Morton's neuroma is a common condition that mainly affects middle-aged women, and many articles have addressed the surgical treatment of this condition. Previous reports have described bilateral neuroma excision in women but not in men. We report a rare case of bilateral neuromas in a male patient treated with simultaneous neurectomy.
Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE



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