Valisena Silvia, Petri Gianfranco John, Ferrero Andrea
Service of Traumatology, Regional Hospital of Bellinzona, Via Ospedale, Bellinzona, Switzerland.
Clinica Luganese Moncucco, Via Moncucco 10, Lugano, Switzerland.
Foot Ankle Surg. 2018 Aug;24(4):271-281. doi: 10.1016/j.fas.2017.03.010. Epub 2017 Apr 5.
The treatment of Morton's neuroma (MN) can be operative, conservative and infiltrative. Our aim was the evaluation of evidence on outcomes with different types of conservative, infiltrative and surgical treatment in patients affected by primary MN.
The bibliographic search was conducted in MEDLINE, Cochrane Library, DARE. Only studies in English were collected. The last search was in August 2015. Case series and randomized controlled trials (RCTs) assessing patients' satisfaction or pain improvement at an average follow-up of at least 6 months after treatment of primary MN were included. Two reviewers selected the studies, evaluated their methodological quality, and retrieved data independently.
Of 283 titles found, only 29 met the inclusion criteria. Data showed better outcomes with operative treatment.
The evaluated case series and few RCTs showed better results with invasive treatment. More and better RCTs which evaluate risk-benefit ratio are required to confirm these results.
Morton 神经瘤(MN)的治疗方法包括手术治疗、保守治疗和注射治疗。我们的目的是评估原发性MN患者采用不同类型的保守治疗、注射治疗和手术治疗的疗效证据。
在MEDLINE、Cochrane图书馆、DARE中进行文献检索。仅收集英文研究。最近一次检索时间为2015年8月。纳入评估原发性MN治疗后平均随访至少6个月时患者满意度或疼痛改善情况的病例系列研究和随机对照试验(RCT)。两名评审员选择研究、评估其方法学质量并独立检索数据。
在找到的283篇标题中,只有29篇符合纳入标准。数据显示手术治疗效果更好。
评估的病例系列研究和少数RCT显示侵入性治疗效果更好。需要更多更好的评估风险效益比的RCT来证实这些结果。