Morton's neuroma is a benign thickening involving the plantar interdigital nerve, most common in middle aged women. Morton's neuroma is one of the most frequent diagnoses seen in the investigators podiatry clinic and is difficult to treat. These lesions cause a burning or shooting pain that can radiate to the toes, or an aching pain in the ball of the foot. The pain is exacerbated with activity and certain footwear greatly limits activity in the involved patient population. Morton's neuroma is first treated conservatively with orthotics. Patients may require further interventions such as steroid injections. The literature reports only a 30% long term resolution of pain with the steroid. Surgical resection has a reported 51-85% success rate with 14-21% rate of complication; recurrent pain, numbness/loss of sensation, and subsequent stump neuromas. Cryoablation is well known to be efficacious for neuropathic pain and has recently been shown in two small studies to be safe and efficacious for treatment of Morton's neuroma. The investigators study will compare outcomes of cryoablation to corticosteroid injection in short- and long-term for treatment of Morton's neuroma that have failed conservative therapy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
Image (ultrasound and fluoroscopic guided) cryoablation will be performed of the Morton's neuroma after nerve block.
Ultrasound and fluoroscopic guided nerve block.
Oregon Health Sciences University
Portland, Oregon, United States
RECRUITINGChanges in quality of life
Will be evaluated using the SF-36 Quality of Life Survey
Time frame: 1 year post procedure
Réponse in pain
Will be evaluated using the visual analog scale with 0 as no pain and 10 as the word pain imaginable
Time frame: 1 year post procedure
Changes to function
Changes to the modified American Orthopedic Foot and Ankle Society Hallux Metatarsophalangeal--Interphalangeal Scale, higher score is less symptomatic
Time frame: 1 year post procedure
Changes pain and function due to neuroma
Changes in Neuroma Scale, higher score is less symptomatic
Time frame: 1 year post procedure
Incidence of Treatment - Emergent Adverse Events
Monitoring for safety of the treatment arm
Time frame: 1 year post procedure
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