The role of diagnostic block in the management of Morton's neuroma

To determine the outcome of surgical excision of Morton's neuroma after a local anesthetic diagnostic block into the neuroma has relieved symptoms. A cohort study. A university affiliated hospital. A sequential series of 37 patients who underwent 41 excisions with at least 2 years' follow-...

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Veröffentlicht in:	Canadian journal of surgery 1998-04, Vol.41 (2), p.127-130
Hauptverfasser:	Younger, A S, Claridge, R J
Format:	Artikel
Sprache:	eng
Schlagworte:	Adult Aged Anesthetics, Local Female Follow-Up Studies Foot Diseases - diagnosis Foot Diseases - surgery Foot Diseases - therapy Humans Male Middle Aged Neuroma - diagnosis Neuroma - surgery Neuroma - therapy Original Orthotic Devices Pain - etiology Postoperative Period Shoes Treatment Failure
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creator	Younger, A S Claridge, R J
description	To determine the outcome of surgical excision of Morton's neuroma after a local anesthetic diagnostic block into the neuroma has relieved symptoms. A cohort study. A university affiliated hospital. A sequential series of 37 patients who underwent 41 excisions with at least 2 years' follow-up. Seven patients had undergone repeat excision of a neuroma, and 34 primary excisions were performed. Surgery was performed by a specialist in orthopedic surgery of the foot and ankle. Excision of the Morton's neuroma after a positive diagnostic block. Grade of symptoms at follow-up done by independent review on a 4-point scale. Of 41 procedures, 11 had an unfavourable outcome: 4 procedures were graded 3, and 7 procedures were graded 4. Eight (24%) of the 34 primary procedures were reported as failures, and 3 (43%) of the 7 revision procedures were reported as failures. Most patients reported poor results owing to persistent pain. Diagnostic blocks do not improve the results of surgery for excision of Morton's neuroma and are not recommended. Because failure rates are greater than 20%, surgery for Morton's neuroma should only be offered after a full course of nonoperative management.
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A cohort study. A university affiliated hospital. A sequential series of 37 patients who underwent 41 excisions with at least 2 years' follow-up. Seven patients had undergone repeat excision of a neuroma, and 34 primary excisions were performed. Surgery was performed by a specialist in orthopedic surgery of the foot and ankle. Excision of the Morton's neuroma after a positive diagnostic block. Grade of symptoms at follow-up done by independent review on a 4-point scale. Of 41 procedures, 11 had an unfavourable outcome: 4 procedures were graded 3, and 7 procedures were graded 4. Eight (24%) of the 34 primary procedures were reported as failures, and 3 (43%) of the 7 revision procedures were reported as failures. Most patients reported poor results owing to persistent pain. Diagnostic blocks do not improve the results of surgery for excision of Morton's neuroma and are not recommended. Because failure rates are greater than 20%, surgery for Morton's neuroma should only be offered after a full course of nonoperative management.</description><identifier>ISSN: 0008-428X</identifier><identifier>EISSN: 1488-2310</identifier><identifier>PMID: 9575995</identifier><language>eng</language><publisher>Canada: Canadian Medical Association</publisher><subject>Adult ; Aged ; Anesthetics, Local ; Female ; Follow-Up Studies ; Foot Diseases - diagnosis ; Foot Diseases - surgery ; Foot Diseases - therapy ; Humans ; Male ; Middle Aged ; Neuroma - diagnosis ; Neuroma - surgery ; Neuroma - therapy ; Original ; Orthotic Devices ; Pain - etiology ; Postoperative Period ; Shoes ; Treatment Failure</subject><ispartof>Canadian journal of surgery, 1998-04, Vol.41 (2), p.127-130</ispartof><rights>1998 Canadian Medical Association 1998</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949825/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949825/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9575995$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Younger, A S</creatorcontrib><creatorcontrib>Claridge, R J</creatorcontrib><title>The role of diagnostic block in the management of Morton's neuroma</title><title>Canadian journal of surgery</title><addtitle>Can J Surg</addtitle><description>To determine the outcome of surgical excision of Morton's neuroma after a local anesthetic diagnostic block into the neuroma has relieved symptoms. A cohort study. A university affiliated hospital. A sequential series of 37 patients who underwent 41 excisions with at least 2 years' follow-up. Seven patients had undergone repeat excision of a neuroma, and 34 primary excisions were performed. Surgery was performed by a specialist in orthopedic surgery of the foot and ankle. Excision of the Morton's neuroma after a positive diagnostic block. Grade of symptoms at follow-up done by independent review on a 4-point scale. Of 41 procedures, 11 had an unfavourable outcome: 4 procedures were graded 3, and 7 procedures were graded 4. Eight (24%) of the 34 primary procedures were reported as failures, and 3 (43%) of the 7 revision procedures were reported as failures. Most patients reported poor results owing to persistent pain. Diagnostic blocks do not improve the results of surgery for excision of Morton's neuroma and are not recommended. 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subjects	Adult Aged Anesthetics, Local Female Follow-Up Studies Foot Diseases - diagnosis Foot Diseases - surgery Foot Diseases - therapy Humans Male Middle Aged Neuroma - diagnosis Neuroma - surgery Neuroma - therapy Original Orthotic Devices Pain - etiology Postoperative Period Shoes Treatment Failure
title	The role of diagnostic block in the management of Morton's neuroma
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