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. 2021 Jun;13(2):266-277.
doi: 10.4055/cios20256. Epub 2021 Apr 22.

Corticosteroid Injection for Morton's Interdigital Neuroma: A Systematic Review

Jun Young Choi  1 , Hyun Il Lee  1 , Woi Hyun Hong  2 , Jin Soo Suh  1 , Jae Won Hur  1
Affiliations

Corticosteroid Injection for Morton's Interdigital Neuroma: A Systematic Review

Jun Young Choi et al. Clin Orthop Surg. 2021 Jun.

Abstract

Backgroud: This review aimed to evaluate the effects of corticosteroid injections on Morton's neuroma using an algorithmic approach to assess the methodological quality of reported studies using a structured critical framework.

Methods: Several electronic databases were searched for articles published until April 2020 that evaluated the outcomes of corticosteroid injections in patients diagnosed with Morton's neuroma. Data search, extraction, analysis, and quality assessments were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). guidelines, and clinical outcomes were evaluated using various outcome measures.

Results: With 3-12 months of follow-up, corticosteroid injections provided satisfactory outcomes according to Johnson satisfaction scores except in two studies. Visual analog scale scores showed maximal pain reduction between 1 week and 3 months after injection. We found that 140 subjects out of 469 (29.85%) eventually underwent surgery after receiving corticosteroid injections due to persistent pain.

Conclusions: Corticosteroid injections showed a satisfactory clinical outcome in patients with Morton's interdigital neuroma although almost 30% of the included subjects eventually underwent operative treatment. Our recommendation for future research includes using more objective outcome parameters, such as foot and ankle outcome scores or foot and ankle ability measures. Moreover, studies on the safety and effectiveness of multiple injections at the same site are highly necessary.

Keywords: Injection; Long term adverse effect; Morton's metatarsalgia; Morton's neuroma; Steroid.

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Conflict of interest statement

CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. A flow diagram of study selection as recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Fig. 2
Fig. 2. The timing of parameter measurements in all included studies.
Fig. 3
Fig. 3. The effect of pain relief using a visual analog scale (VAS) after corticosteroid injection.
Fig. 4
Fig. 4. Summary of answers to the research questions posed in the introduction.
Fig. 5
Fig. 5. Comparison of the number of included studies in previous systematic reviews and our study.
See this image and copyright information in PMC

References

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