Faulkner Alastair, Mayne Alistair, Davies Peter, Ridley David, Harrold Fraser
Department of Trauma and Orthopaedics, Ninewells Hospital, Dundee, Scotland, UK.
Department of Trauma and Orthopaedics, Ulster Hospital, Belfast, Northern Ireland.
Foot Ankle Int. 2021 Feb;42(2):151-156. doi: 10.1177/1071100720961069. Epub 2020 Oct 5.
Morton's neuroma is associated with chronic pain and disability. There is a paucity of literature regarding patient-related outcome measures (PROMs) in patients managed nonoperatively. We sought to investigate nonoperative and operative management of Morton's neuroma using PROMs in patients with follow-up to 1 year.
We conducted a prospective observational study and collected data on all patients with a new diagnosis of Morton's neuroma treated from February 2016 until April 2018. Primary outcome measures were the Manchester-Oxford Foot Questionnaire (MOXFQ) for pain, EuroQoL (EQ) time trade-off (TTO), and EQ visual analog scale (VAS) taken preoperatively and at 52 weeks postoperatively. Forty-four patients were treated nonoperatively and 94 patients were treated operatively.
Pretreatment and 52-week scores were 55.7 and 43.10 (nonoperative) and 63.7 and 40.1 (operative) for MOXFQ (pain), 0.72 and 0.82 (nonoperative) and 0.68 and 0.82 (operative) for EQ-TTO, and 71.5 and 76.2 (nonoperative) and 73.1 and 68.7 (operative) for EQ-VAS. There was a statistically significant improvement in MOXFQ (pain) in nonoperative ( = .02) and operative groups ( < .001). There was a statistically significant improvement in EQ-TTO in the operative group only ( = .01).
This is the largest study investigating outcomes to 12 months of both nonoperative and operatively managed patients with Morton's neuroma. Both nonoperative and operative management lead to symptom improvement at 12 months.
Level III, comparative study.
莫顿神经瘤与慢性疼痛和功能障碍相关。关于非手术治疗患者的患者相关结局指标（PROMs）的文献较少。我们试图通过对患者进行长达1年的随访，使用PROMs来研究莫顿神经瘤的非手术和手术治疗。
我们进行了一项前瞻性观察研究，收集了2016年2月至2018年4月期间所有新诊断为莫顿神经瘤患者的数据。主要结局指标为术前和术后52周采用的用于评估疼痛的曼彻斯特-牛津足部问卷（MOXFQ）、欧洲生活质量量表（EQ）时间权衡法（TTO）以及EQ视觉模拟量表（VAS）。44例患者接受非手术治疗，94例患者接受手术治疗。
MOXFQ（疼痛）方面，非手术组治疗前和52周时的评分分别为55.7和43.10，手术组为63.7和40.1；EQ-TTO方面，非手术组为0.72和0.82，手术组为0.68和0.82；EQ-VAS方面，非手术组为71.5和76.2，手术组为73.1和68.7。非手术组（P = .02）和手术组（P < .001）的MOXFQ（疼痛）均有统计学意义的改善。仅手术组的EQ-TTO有统计学意义的改善（P = .01）。
这是对非手术和手术治疗的莫顿神经瘤患者进行长达12个月结局研究的最大规模研究。非手术和手术治疗均可在12个月时改善症状。
III级，比较性研究。
