Department of Orthopedics and Trauma Surgery, University of Verona, Italy.
Orthopaedic Department, University of Genova, Italy.
Foot Ankle Surg. 2021 Jun;27(4):357-365. doi: 10.1016/j.fas.2020.05.001. Epub 2020 May 18.
The aim of this paper is to analyze the effectiveness of corticosteroid injections (CI), in combination with or without a local anaesthetic, for Civinini-Morton's Syndrome to determine which protocol could be the most appropriate among conservative treatments.
All selected articles were screened using a thorough database search of PubMed, EMBASE and SCOPUS to assess their suitability to the research focus.
Selection produced 10 articles as full-text, for a total of 590 patients, with a mean follow-up of 14 ± 14.2 (range 3-48) months. Johnson satisfaction scale, resulting from 6 studies, scored 25.6% (range 5-38) and 39.4% (range 15-51.8), respectively completely satisfied and satisfied with minor reservations. Mean VAS, declared in 5 studies, decreased from 70.7 ± 16.5 (range 67-89) to 33.4 ± 7.6 (26-42.5) points (p < 0.01). Most common complication was skin depigmentation in 7 (2.6%) cases.
CI appear to be a safe treatment allowing good results with a very low complications rate. A neuroma of 6.3 mm seems to be the cut-off size; below which CI could have best indications and be considered as an intermediate treatment between shoe modifications and more invasive procedures such as percutaneous alcoholization or surgery.
Level II, systematic review.
本文旨在分析皮质类固醇注射（CI）联合或不联合局部麻醉剂治疗 Civinini-Morton 综合征的有效性，以确定在保守治疗中哪种方案最合适。
通过对 PubMed、EMBASE 和 SCOPUS 数据库进行全面检索，筛选出所有符合研究重点的文章。
共筛选出 10 篇全文文章，总计 590 例患者，平均随访时间为 14±14.2（3-48）个月。6 项研究的 Johnson 满意度评分分别为 25.6%（5-38）和 39.4%（15-51.8），完全满意和基本满意。5 项研究报告的平均 VAS 评分从 70.7±16.5（67-89）降至 33.4±7.6（26-42.5）（p<0.01）。最常见的并发症是 7 例（2.6%）皮肤色素减退。
CI 似乎是一种安全的治疗方法，可获得良好的效果，并发症发生率极低。6.3mm 的神经瘤似乎是一个临界点；在此之下，CI 可能具有最佳适应证，并可被视为鞋类修改与更具侵袭性的治疗方法（如经皮酒精注射或手术）之间的中间治疗。
二级，系统评价。
