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LOCAL PHENOL INJECTION IN THE TREATMENT OF INTERDIGITAL NEURITIS OF THE FOOT (MORTON’S NEUROMA)



Abstract

Introduction: Symptomatic treatment of Civinini-Morton syndrome (interdigital neuritis: IDN) may be performed directly on the involved nervous branch using orthotics, local drug injections or surgery.

Alcoholization with phenol by a percutaneous approach has the aim to induce a permanent chemical neurolysis, obtaining remission of the neuritic painful symptoms.

Methods: 71 patients were treated by percutaneous alcoholization of the interdigital nerve using a needle-electrode connected to an electrostimulator by a dorsal approach to the intermetatarsal space. Once the nerve is localized by induction of paresthesia up to the toes, 2,5 ml of phenol 5% in water solution are injected, immediately followed by local anesthetic for a post-procedure analgesia. The patients were evaluated by visual analogue scale for pain (VAS).

Results: Mean follow-up was 36±8 months. Percutaneous alcoholization of the common interdigital nerve by phenol injection proved to be effective (VAS < 30) in 80.3% of cases (57/71).

Conclusions: Treatment of Civinini-Morton syndrome by alcoholization with phenol by a percutaneous approach showed considerable better results when compared with those reported in the literature with conservative treatment or local steroid injection, and even comparable with those obtained with surgical nevrectomy in absence of complications related to surgical approach.

Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Email: office@efort.org