Treatments for Morton's neuroma.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: BM: none known; BM is a podiatrist and manages people with Morton's neuroma. He authored a 2019 systematic review of non‐surgical interventions for Morton's neuroma. CT: none known; CT is a surgical podiatrist and manages people with Morton's neuroma. He is an author of an RCT funded by the Chief Scientist Office Scottish Government, which is relevant to this systematic review. CT resolved study inclusion, data extraction, risk of bias and GRADE appraisal disagreements except for the included study (Thomson 2013), which he co‐authored. JM: none known; JM is an orthopaedic surgeon who manages people with Morton's neuroma. MH: none known; MH is a podiatrist and manages people with Morton's neuroma. He co‐authored a 2019 systematic review of non‐surgical interventions for Morton's neuroma. RW: none known; RW is an academic biostatistician. He co‐authored a 2019 systematic review of non‐surgical interventions for Morton's neuroma. RW is a Cochrane editor who was not involved in the editorial process for this review. 4. Ther Umsch. 2024 Dec;81(7):240-244. doi: 10.23785/TU.2024.07.002. [Metatarsalgia]. [Article in German; Abstract available in German from the publisher] Inglin F(1)(2), Knupp M(1). Author information: (1)Mein Fusszentrum, Basel. (2)fabienne.inglin@meinfusszentrum.ch. Metatarsalgia is a generic term for complaints in the forefoot and the metatarsophalangeal joints II-IV. However, it does not describe a specific clinical picture but rather a complex of symptoms, which can have different causes. There are mechanical causes, e.g. due congenital or acquired malformations of the foot. Splayfeet with a bunion malformation combined with transfer a common cause. Other examples include brachimetatarsalgia or an instability of the first ray. Other, non-mechanical causes are Morton's neuroma, stress fractures, systemic diseases (rheumatoid arthritis, gout) or infections and aseptic necrosis. Metatarsalgia is described as stress-dependent pain in the ball of the forefoot, which often has a burning or stabbing character. Sometimes a foreign body feeling is reported, as if one were walking on a «pebble». Wearing tight and hard shoes further provokes the symptoms. The therapy depends on the causes and should initially cover conservative options. This includes wearing proper shoes, foot gymnastic/stretching exercise, orthopedic insoles or even orthopedic shoes. Surgical options comprise of Morton's neuroma removal, deformity correction and ligament reconstruction. Publisher: TITEL: Metatarsalgie. EINLEITUNG: Die Metatarsalgie ist ein Oberbegriff für Beschwerden am Vorfuss im Bereich der Metatarsophalangealgelenke II–V. Sie beschreibt kein konkretes Krankheitsbild, sondern einen Symptomkomplex, welcher unterschiedliche Ursachen haben kann. Ursächlich infrage kommen mechanische (meist eine relative Überlänge des 2. und 3. Metatarsales), neurologische (Morton-Neurinom) und systemische Erkrankungen (rheumatoide Arthritis, Gicht). Seltenere Ursachen sind Stressfrakturen, Infekte und aseptische Nekrosen. Beschrieben wird die Metatarsalgie mit belastungsabhängigen Schmerzen im Vorfussballen, welche oft einen brennenden oder stechenden Charakter haben. Manchmal wird auch von einen Fremdkörpergefühl berichtet, als laufe man auf einem «Kieselstein». Das Tragen von engen und harten Schuhen provoziert die Beschwerden zusätzlich. Die Therapie ist in den meisten Fällen konservativ und umfasst das Tragen von angepasstem Schuhwerk, Fussgymnastik/Dehnungsübungen und orthopädische Schuheinlagen. Chirurgisch können Morton-Neurinome entfernt werden und Fehlstellungen und Überlängen der Metatarsalia korrigiert werden. Schlüsselwörter: Metatarsalgie, Vorfussbeschwerden, konservative Therapie, chirurgische Behandlung, Morton-Neurinome. © 2024 Aerzteverlag medinfo AG. DOI: 10.23785/TU.2024.07.002