Digital Ischemia after Ultrasound-Guided Alcohol Injection for Morton’s Syndrome: Case Report and Review of the Literature

Abstract

The therapeutic algorithm for symptomatic Morton’s syndrome is not standardized as several managements have been proposed. Ultrasound-guided alcohol injection (USGAI) is one of the non-operative procedures described. This report presents the case of digital ischemia that occurred after alcoholization for the treatment of Morton’s syndrome. This complication is described for the first time in the scientific literature, and it should not only be added to the list of sequalae of USGAI, but more importantly, it should also be explained to the patient when this alternative treatment to traditional surgery is proposed.

Is Morton's neuroma in a pes planus or pes cavus foot lead to differences in pressure distribution and gait parameters?

“…Instead of non-invasive approaches which may disrupt foot biomechanics and gait patterns, local approaches should be used to reduce the effects of MN. Since the complication ratio of local applications is very low, it can be preferred in the restoration of possible gait disorders due to MN [ 38 ].…”

Infiltrative Type I Collagen in the Treatment of Morton’s Neuroma: A Mini-Series

“…Therefore, some authors have called this pathology Civinini-Morton syndrome (CMS) [3]. Predisposing conditions are female gender; the use of high-heeled, narrow-soled shoes; athletic activities that cause repetitive foot trauma; and foot deformities such as hammertoes, pes cavus or flatfoot [4,5]. MN is characterized by continuous common digital plantar nerve (CDPN) pain; in fact, this condition is known as "neuroma".…”

“…The MN pathology presents with a broad spectrum of symptoms, including paresthesia, metatarsalgia and stabbing pain in the metatarsal plantar region [7]. The symptoms could also involve the nearby toes and other parts of the foot [4]. This clinical condition adversely affects the social aspect of normal life, as well as gait, shoe use and upright posture.…”

“…Essentially, it is possible to divide clinical approaches with curative intent into two main lists: the first includes all conservative procedures (CPs), while the second includes unconservative procedures (UPs). Biz et al [4] recently described a detailed list of techniques used for the management of MN. The list of CPs certainly includes corticosteroid injection, radiofrequency ablation (RFA), fascial manipulation [7], laser therapy and alcohol injection [4].…”

“…Biz et al [4] recently described a detailed list of techniques used for the management of MN. The list of CPs certainly includes corticosteroid injection, radiofrequency ablation (RFA), fascial manipulation [7], laser therapy and alcohol injection [4]. Most of them were carried out with the support of US-guided (USG) procedure [11,12].…”