Sclerosing alcohol injections for the management of intermetatarsal neuromas: A systematic review

The Foot
Derek SantosAndrea Coda

Abstract

An intermetatarsal neuroma is a plantar digital neuritis causing metatarsalgia of the affected inter-metatarsal space. At present the evidence to support the management of the condition is poor with only some quality evidence supporting the short-term management of intermetatarsal neuromas using steroid injections. Some authors have supported the use of alcohol sclerosing intra-lesional injections to treat intermetatarsal neuromas. Following a search of the evidence 11 articles were identified. The systematic review found that alcohol injections appear to be safe although some papers report a short-term side effect of a flogistic reaction and there are variances in the alcohol concentration used and guiding verses not guiding the injection using ultrasound imaging. Some of the evidence may suggest a sclerosing histological effect of the nerve. However, all the studies reviewed present a research design offering a low level of evidence that is open to methodological biases and interpretation. Thus, this review found insufficient high-quality research evidence to afford conclusions on the management of intermetatarsal neuromas with alcohol sclerosing agent injections.

Citations

Feb 6, 2020·Foot & Ankle International·Christof PabingerBruno Magnan
Dec 11, 2020·Journal of the American Podiatric Medical Association·Alvaro Iborra-MarcosPablo Sanz-Ruiz
Nov 3, 2020·Plastic and Reconstructive Surgery·Steven T LanierGregory A Dumanian

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