The comparison of postoperative outcomes in Morton's neuroma excision between plantar versus dorsal approach: A systematic review and meta-analysis.

Autor: Lee W; Department of Orthopaedic Surgery, Guthrie Clinic, 1 Guthrie Sq, Sayre 18840, PA, USA. Electronic address: wonyonglee.md@gmail.com., McDonald J; Geisinger Commonwealth School of Medicine, 525 Pine St, Scranton 18510, PA, USA. Electronic address: jpmcdonald1418@gmail.com., Azam M; Department of Orthopaedic Surgery, Guthrie Clinic, 1 Guthrie Sq, Sayre 18840, PA, USA. Electronic address: mohammad.azam@guthrie.org., Lachance AD; Department of Orthopaedic Surgery, Guthrie Clinic, 1 Guthrie Sq, Sayre 18840, PA, USA. Electronic address: andrewdlachance@gmail.com.
Jazyk: angličtina
Zdroj: Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons [Foot Ankle Surg] 2024 Dec; Vol. 30 (8), pp. 621-629. Date of Electronic Publication: 2024 Jun 05.
DOI: 10.1016/j.fas.2024.05.018
Abstrakt: Background: Current literature lacks comprehensive information comparing the clinical outcomes of plantar and dorsal approaches for Civinini-Morton syndrome, also known as Morton's neuroma. This systematic review and meta-analysis was conducted to evaluate and compare the clinical outcomes of neurectomy for Morton's neuroma, focusing on the differences between the plantar and dorsal approach.
Methods: Our comprehensive literature review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and utilized databases including PubMed, Embase, Web of Science, and the Cochrane Library. Data investigated in this study included postoperative sensory loss, scar tenderness, reoperation, histopathology, complications, pain score, patient satisfaction, functional scores, and time to weight bearing.
Results: Total eight studies were included in this study. In aggregate, 237 neuromas underwent excision using the plantar approach, while 312 neuromas were treated via the dorsal approach. A significantly higher rate of postoperative reduced sensory was found in the dorsal group: 48.5 % (64/132) Vs. 62.0 % (80/129) with the relative ratio (RR) of 0.79 (95 % CI, 0.64-0.97). A significantly higher rate of postoperative scar tenderness was noted in the plantar group: 16.7 % (32/192) Vs. 6.2 % (14/225) with the RR of 2.27 (95 % CI, 1.28-4.04). Regarding the histopathology, 99.3 % (143/144) and 97.1 % (134/138) accuracy rate was confirmed in the plantar approach and dorsal approach, respectively, with the RR of 1.02 (95 % CI, 0.98-1.07). Overall reoperations and complications were not different between groups at 5.3 % (10/189) and 8.8 % (19/216) in the plantar group versus 6.1 % and 12.0 % (35/291) in dorsal group.
Conclusions: We recommend detailed discussions with patients prior to surgery to weigh the advantages and disadvantages of each approach.
Competing Interests: Declaration of Competing Interest The authors have no potential conflict of interest with respect to the research, authorship, and/or publication of this article. ICMJE forms for all authors are available online.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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