title: Alcohol injection for Morton's neuroma: a five-year follow-up.
abstract: BACKGROUND
  Although many treatment modalities are available for Morton's neuroma (MN), studies looking at the long-term effectiveness of most forms of treatment are scarce. The injection of MN with alcohol has gained popularity over the past 10 years with widespread media coverage. Many surgeons have anecdotally questioned the long-term effectiveness of this treatment. We reviewed a cohort of patients at an average 5-year follow-up to assess the medium-term results of alcohol injection.
  
  
  METHODS
  We used the modified Johnson score and visual analogue scales to assess 45 of the original cohort of patients with an average follow-up of 61 months (range, 33-73 months). Any complications from the procedure were also noted.
  
  
  RESULTS
  Our results indicated that by 5 years, 16 of 45 patients had undergone surgical treatment and a further 13 patients had return of symptoms. Only 29% (13/45) remained symptom free. The visual analog scale and modified Johnson scores showed statistically significant deterioration in patients' symptoms at 5 years following alcohol injection.
  
  
  CONCLUSIONS
  Injection with alcohol sclerosant for MN has been marketed as a definitive management option comparable to surgical excision. Our investigation illustrated that although short-term results are encouraging, alcohol injection does not offer permanent resolution of symptoms for most patients and can be associated with considerable morbidity. Our investigation provides the only long-term data for alcohol injection treatment of MN.
  
  
  METHODS
  Level II, prospective case series.
authors.affiliation: Kingston Hospital NHS Trust, Kingston-upon-Thames, UK. sabahatg@hotmail.com
authors.forename: Sabahat
authors.initials: S
authors.lastname: Gurdezi
authors.forename: Thomas
authors.initials: T
authors.lastname: White
authors.forename: Palanisamy
authors.initials: P
authors.lastname: Ramesh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000438:Alcohols / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D009463:Neuroma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000438:Alcohols; D012597:Sclerosing Solutions
keywords: Morton’s neuroma; alcohol injection; interdigital neuroma; neuroma; sclerosant injection