Hassouna Hazem, Singh Dishan, Taylor Heath, Johnson Steve
Foot and Ankle Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom.
Acta Orthop Belg. 2007 Apr;73(2):224-9.
The aim of this study was to assess the clinical effectiveness of ultrasound guided injection in the management of Morton's Metatarsalgia. Patients clinically diagnosed with interdigital Morton's neuroma were treated with ultrasound guided injection of local anaesthetic and steroid. Fifty four patients were available for follow-up, and all had detailed telephone questionnaires completed. These questionnaires included a pre and post injection symptom score, and Johnson Satisfaction score. The results indicate that 69% of patients had ultrasound diagnosis of Morton's neuroma and 31% had an ultrasound diagnosis of intermetatarsal bursa. Mean follow-up was 11.4 months. Sixty seven percent of the patients were satisfied with the results of treatment. At follow-up 63% of patients had no limitation in activity levels, and had no need to modify shoe wear. Of all patients included in the study, only three have gone on to require surgery for ongoing symptoms. Although some studies have suggested that neither injection nor imaging have a role in the treatment of Morton's neuroma, this study, however, demonstrates that ultrasound guided placement of local anaesthetic and steroid in either an intermetatarsal bursa or Morton's neuroma gives a good short and medium-term symptom relief and in the majority of cases avoids or at least delays the need for surgery.
本研究的目的是评估超声引导注射在治疗莫顿跖痛症中的临床效果。临床诊断为指间莫顿神经瘤的患者接受了超声引导下局部麻醉剂和类固醇的注射治疗。54例患者可供随访，所有患者均完成了详细的电话调查问卷。这些问卷包括注射前后的症状评分和约翰逊满意度评分。结果表明，69%的患者经超声诊断为莫顿神经瘤，31%的患者经超声诊断为跖间滑囊炎。平均随访时间为11.4个月。67%的患者对治疗结果满意。随访时，63%的患者活动水平无限制，无需改变鞋类穿着。在纳入研究的所有患者中，只有3例因持续症状而需要进行手术。尽管一些研究表明注射和影像学检查在莫顿神经瘤的治疗中均无作用，但本研究表明，超声引导下在跖间滑囊炎或莫顿神经瘤中注射局部麻醉剂和类固醇可在短期和中期有效缓解症状，且在大多数情况下可避免或至少推迟手术需求。
