Neoplasms

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Morton Neuroma

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Percoutaneous blind injection in Morton neuroma by subcutaneous needle group 1 are going to be injected by an experimented orthopaedic surgeon based on anatomic landmark. There is no internal control of the needle placement.

Mixture of 1 cc of 2% mepivacaine (Mepivacaina Normon 2%® )+ 40 mg of triamcinolone (Trigon Depot®) in each of the web spaces affected with Morton neuroma is injected.

Up to 4 injections are allow in the first three months of follow-up

1 cc of 2% mepivacaine (Mepivacaina Normon 2%® )+ 40 mg of triamcinolone (Trigon Depot®) in each of the web spaces affected with Morton neuroma is injected.

Up to 4 injections are allow in the first three months of follow-up

40 mg of triamcinolone (Trigon Depot®) in each of the web spaces affected with Morton neuroma is injected. Up to 4 injections are allow in the first three months of follow-up

US guided injection in Morton neuroma by subcutaneous needle. group 2 are going to be injected by an experimented musculoskeletal radiologist under ultrasound guidance. There is internal control of needle placement by ultrasound.

2% mepivacaine (Mepivacaina Normon 2%® ) in each of the web spaces affected with Morton neuroma is injected.

Up to 4 injections are allow in the first three months of follow-up

Introduction of a needle based in anatomical landmark

blind injection of Morton neuroma

blind injection of 1 cc of Mepivacaine Normon 2% ®

blind injection of Mepivacaine

blind injection of 40 mg of triamcinolone (trigon depot ®)

blind injection of Triamcinolone

Introduction of a needle based guided by ultrasound

ultrasound guided injection

ultrasound guided injection of 1 cc of Mepivacaine Normon 2% ®

guided injection of mepivacaine

ultrasound guided injection of 40 mg of triamcinolone (trigon depot ®)

guided injection of Triamcinolone

PABLO TOMAS MUÑOZ, PhD

ANA MARIA DEL VALLE DIAZ DE LA GUARDIA, MD

JUANA MARIA DE HARO CASTELLANO

JUAN MORALES ARCAS

NICOLAS PRADOS OLLETA, PhD

PABLO TOMAS MUÑOZ

FERNANDO RUIZ SANTIAGO, PhD

The aim of this work trial is to compare the effectiveness of blind and ultrasound guided injection for Morton neuroma in order to determine which is more appropriate as the initial procedure in conservative treatment

This is a evaluator-blinded randomized trial. The final sample size has been calculated to be 100 patients. 50 of group 1 are going to be injected by an experimented orthopaedic surgeon based on anatomic landmark. 50 of group 2 are going to be injected by an experimented musculoskeletal radiologist under ultrasound guidance.

The inclusion criteria are clinical suspicion of Morton neuroma confirmed in ultrasound scan. Included patients are assessed clinically by VAS score, the Manchester Foot Pain and Disability Schedule (MFPDS), and a generic quality-of-life instrument, the EQ-5D.

Injection includes 1 cc of 2% mepivacaine and 40 mg of triamcinolone in each web space with Morton Neuroma. According evolution until 4 injections were allowed the first 2 months of follow-up, Follow up was performed by phone calls and/or scheduled consultations at 15 days, 1 month, 45 days, 2 months, 3 months, 6 months and 1 year.

Statistical analysis was performed by unpaired Student's t test

Blind and Ultrasound Guided Injection in Morton Neuroma

Comparison Between Blind and Ultrasound Guided Injection in Morton Neuroma

our idea is to publish the short term results and the long term results in order to influence management of this pathology. Tables and statistical analysis will be available for review and metaanalysis.

Spots Global Cancer Trial Database for guided injection of mepivacaine