Effectiveness of corticosteroid injections in Civinini-Morton's Syndrome: A systematic review.


Journal

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons
ISSN: 1460-9584
Titre abrégé: Foot Ankle Surg
Pays: France
ID NLM: 9609647

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 12 11 2019
revised: 07 04 2020
accepted: 04 05 2020
pubmed: 1 7 2020
medline: 8 7 2021
entrez: 1 7 2020
Statut: ppublish

Résumé

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.

Sections du résumé

BACKGROUND BACKGROUND
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.
METHODS METHODS
All selected articles were screened using a thorough database search of PubMed, EMBASE and SCOPUS to assess their suitability to the research focus.
RESULTS RESULTS
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.
CONCLUSIONS CONCLUSIONS
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 OF EVIDENCE METHODS
Level II, systematic review.

Identifiants

pubmed: 32600970
pii: S1268-7731(20)30081-3
doi: 10.1016/j.fas.2020.05.001
pii:
doi:

Substances chimiques

Adrenal Cortex Hormones 0

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

357-365

Informations de copyright

Copyright © 2020 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Auteurs

Elena Samaila (E)

Department of Orthopedics and Trauma Surgery, University of Verona, Italy.

Gabriele Colò (G)

Orthopaedic Department, University of Genova, Italy.

Alessandro Rava (A)

Department of Orthopaedic and Traumatology, University of Turin, Italy.

Stefano Negri (S)

Department of Orthopedics and Trauma Surgery, University of Verona, Italy.

Roberto Valentini (R)

Department of Orthopedics and Trauma Surgery, University of Verona, Italy.

Lamberto Felli (L)

Orthopaedic Department, University of Genova, Italy.

Bruno Magnan (B)

Department of Orthopedics and Trauma Surgery, University of Verona, Italy. Electronic address: bruno.magnan@univr.it.

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Classifications MeSH