• 대한족부족관절학회지
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• 제10권1호
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• pp.80-83
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• 2006

Purpose: To compare ultrasonographic size of morton's neuroma measured to actual size. Materials and Methods: Thirty-two (twenty-eight patients) of symptomic Morton's neuroma were measured by ultrasonography preoperatively and by manual method that designed by authors intraoperatively from January, 2002 to May, 2003. Two results were stastically compared by paired T-test. Results: Except one, all of cases were women and the mean age of patients was 50.6 years (32-62 years). The most common associated disease was hallux valgus deformity (17 cases). Six of Morton's neuromas located on second intermetatarsal space, sixteen of them did third intemetatarsal space and ten of neuromas located simultaneously second and third intermetatarsal space. The ultrasonographic size of neuroma averaged 3.48 mm and real size was 3.99 mm. The size checked by manual method was larger than by ultrasound with statical meaning. Conclusion: The size of Morton's interdigital neuroma checked by ultrasonography on plantar aspect is smaller than real size. If you checked Morton's interdigital neuroma size by ultrasonography, you can suspect that real size of Morton's interdigital neuroma is larger than that size.

• 대한족부족관절학회지
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• 제10권1호
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• pp.31-36
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• 2006

Purpose: To evaluate the usefulness of ultrasound and MRI in diagnosing Morton's Neuroma, and the effect and significance of stepwise treatment. Materials and Methods: Out of all patients suspected of Morton's neuroma through history taking and physical examination, 77 patients (84 feet, 95 lesions) in whom Morton's neuroma was confirmed by ultrasound or MR imaging study or was clinically suspected with negative imaging studies, and followed up for over 3 months were included. In all cases, history taking and imaging study were done, and by comparison with operative findings of the patients, the sensitivity of ultrasound and MRI was checked. Postoperative evaluation was done using the AOFAS scale. The patient's satisfaction was also examined. Results: Morton's neuroma occurred most frequently at the $3^{rd}$ web space of the foot (56%), followed by the $2^{nd}$ web space (44%). Out of 15 cases suspected of morton's neuroma through ultrasound study, 13 were pathologically positive showing a sensitivity of 85.7%. Out of 16 cases suspected of morton's neuroma through MRI, 14 were pathologically positive showing a sensitivity of 83.3%. There was no significant difference in sensitivity between the two imaging modalities. Conclusion: In diagnosing Morton's neuroma, ultrasound examination had a similar sensitivity with MRI, therefore can be used as a screening study.

• 대한족부족관절학회지
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• 제12권1호
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• pp.106-110
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• 2008

Morton's neuroma has been treated with resection of the enlarged interdigital nerve by most of surgeons, but the numbness after resection could bother the patients. We reported the experiences of the good results after treatment of Morton's neuroma with the decompression of the interdigital nerve. Three patients, 4 feet were diagnosed to Morton's neuroma and taken the surgery, decompression of the interdigital nerve after the conservative treatments. The decompression can be considered first as another choice of treatment for interdigital neuroma before resection of the nerve.

• 대한족부족관절학회지
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• 제19권2호
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• pp.58-62
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• 2015

Purpose: The purpose of this report is to investigate the clinical and radiological results of corrective osteotomy of the 3rd metatarsal bone for shortening and dorsal displacement without exposure around neuroma. Materials and Methods: Twelve cases of patients who underwent corrective osteotomy of metatarsal bone for a Morton's neuroma from November 2013 to September 2014 were retrospectively reviewed. Corrective osteotomy was performed through a dorsal approach at the 3rd metatarsal bone base and distal metatarsal bone was displaced dorsally and proximally. Preoperative and postoperative pain assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and radiographs were evaluated. Results: The mean age of patients was 41.4 years, and the mean follow-up period was 10.7 months. AOFAS score improved from 52 preoperatively to 90 postoperatively. The 3rd metatarsal bone was shortened by an average of 3.39 mm and elevated by 2.38 mm. Conclusion: Corrective osteotomy of metatarsal bone can be regarded as a new surgical option for Morton's neuroma without exposure around neuroma.

• 대한족부족관절학회지
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• 제15권2호
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• pp.58-61
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• 2011

전족부 통증의 주요 원인 중의 하나인 모턴씨 신경종, 즉 족지간 신경염은 진정한 종양이 아니라 신경 포착 증후군의 일종으로 이해되고 있으며, 진단 시 정확한 이학적 검사와 함께 전족부 통증의 원인이 되는 다른 질환과도 감별해야 한다. 치료에 있어서는 적절한 보존적 치료에도 증상 호전이 되지 않는 환자에게 수술적 치료로서 신경절제술이 주로 시행되어 약 80%의 환자가 만족하는 좋은 결과를 보고하고 있으나, 수술 후 만족스럽지 않은 결과를 보이는 2~35%의 환자를 적절히 처치함으로써 족지간 신경염의 치료 결과를 좀 더 만족스럽게 할 수 있을 것이다.

• 대한족부족관절학회지
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• 제9권1호
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• pp.131-134
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• 2005

Purpose: The purpose of this study was to investigate the clinical results of conservative treatment for Morton's neuroma and to analyze the factors which influenced on the results. Materials and Methods: In this retrospective study, 101 cases of 83 patients with interdigital neuroma were conservatively treated with follow-up period of at least 6 months. There was no significant difference in results among different age groups, sxes, and lesion sites. However, the results were significantly better if the treatment was started within 6 months after onset. Results: We had 28 excellent results (28%), and 13 good results (13%). Patients were grouped by sex, age, duration of symptom before treatment, affected location. The result of treatment was evaluated by comparing the subject pain and discomfort score of the first vist and last follow-up. Conclusion: There are excellent results over 41% by conservative treatment. The results of conservative treatment were not related to age, sex, and lesion site, but were related to pre-treatment period. The shorter the pretreatment period was, the better the results.

• 대한족부족관절학회지
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• 제7권1호
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• pp.131-134
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• 2003

Most interdigital neuroma can be diagnosed clinically. But, diagnostic local injection method, sonography and magnetic resonance image(MRI) have been used as secondary tests for clinical confirmation or surgery. Recently, there have been active discussions on the method of interdigital neuroma diagnosis for which sonography or MRI is used. For finding out the location or the number of interdigital neuroma particularly in non-typical clinical manifestation or surgery, MRIs, which are exellent in tissue contrast, may be quite helpful. This case had an interdigital neuroma showing non-typical manifestation. MRIs were used for clinical diagnostic confirmation and finding out the location and the number of interdigital neuroma. Thus, the validity along with literary consideration is being reported.

• 대한정형외과 초음파학회지
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• 제5권2호
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• pp.61-65
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• 2012

목적: 족부에 발생하는 여러 질환 중 모톤씨 신경종은 종족골두 사이에서 지속적인 마찰로 인한 자극으로 발생되며 보행 시 통증과 감각이상을 호소한다. 일차적인 치료는 중족골 패드, 스테로이드 주사, 비스테로이드성 진통제를 사용하는 비수술적인 치료 방법이 권장되고 있다. 초음파의 발달로 인해 모톤씨 신경종을 진단하고 그 크기를 쉽게 확인 할 수 있으며 스테로이드도 정확한 부위에 주사할 수 있게 되었다. 이에 저자들은 초음파 영상 하의 스테로이드 주사에 대한 임상적 결과를 분석하고자 하였다 대상 및 방법: 2008년 10월부터 2011년 9월까지 임상적 및 초음파 검사 하에서 모톤씨 신경종으로 진단받은 17명(23례)을 대상으로 연구를 시행하였다. 모든 환자가 여성이었고, 평균 나이는 52.6세(36~72)이었다. 병변의 종축과 횡축의 크기를 측정하였고, 5 mg의 dexamethasone을 초음파 영상 유도 하에 신경종 주위에 주사하였다. 주사 전, 후의 자가 통증 점수(VAS pain score)를 기록하였고, 주사 후 환자의 만족도를 완쾌, 호전, 비호전, 악화로 분류 하였으며 SPSS 프로그램을 이용한 t-test를 이용하여 병변의 크기에 따른 steroid 주사의 효과를 비교 분석하였다. 결과: 1예에서 제1 중족지간에, 11예에서 제2 중족지간에 신경종이 발생하였고, 11예는 제3 중족지간에 발생하였다. 신경종의 평균 종축의 길이는 $0.8{\pm}0.4cm$, 횡축의 길이는 $0.52{\pm}0.17cm$이었다. 총 23례 중 증상의 완쾌 및 호전은 7례(30.4%)이었고 비호전 및 악화의 예는 16례(69.6%)이었다. 만족도가 완쾌 및 호전이었던 군의 신경종 종축의 평균길이는 $0.71{\pm}0.39cm$이었고 횡축의 평균 길이는 $0.47{\pm}0.24cm$이었으며, 만족도가 비호전 및 악화 이었던 군의 신경종 종축의 크기는 $0.83{\pm}0.42cm$, 횡축의 길이는 $0.54{\pm}0.14cm$이었다. 종축의 길이가 5 mm 미만, 횡축의 크기가 4 mm 미만인 신경종 군에서 주사 후 자가 통증 점수와 만족도가 종축이 5 mm, 횡축이 4 mm이상인 신경종보다 통계학적으로 의미 있게 임상 결과가 좋은 것으로 분석되었다(p<0.05). 결론: 모톤씨 신경종에서 초음파 영상은 진단 및 치료에 중요한 영상기법으로 생각되며 신경종의 횡축 길이가 0.5 cm, 종축 길이가 0.4 cm 미만인 경우에는 스테로이드 주사가 효과적인 것으로 사료된다.

• 대한족부족관절학회지
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• 제17권3호
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• pp.203-208
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• 2013

Purpose: We analyzed retrospectively the effect of pyridoxine in the treatment of peripheral nerve related foot pain because we have seen favorable clinical results from it as a monotherapy. Materials and Methods: We analyzed the clinical results of 200 cases of peripheral nerve related foot pain, treated with pyridoxine from March 2009 to February 2012. We devided them into three groups, peripheral neuritis, Morton's neuroma and posttraumatic neuralgia and recorded percentage of improvement of pain, compared to initial pain level at 2 weeks and 6 weeks. Results: There were 127 peripheral neuritis cases, 22 Morton's neuroma and 51 posttraumatic neuralgia. At 2 weeks after treatment, 135 cases(67.5%) showed pain relief. At 6 weeks, 36 cases(21%) showed complete improvement of pain, 81 cases(47%) showed more than 50 % of improvement, 22 cases(13%) showed less than 50% of improvement and 33 cases(19%) showed no improvement. There are 4 cases of gastrointestinal discomfort and 2 cases of aggravation of nervy pain. Conclusion: Pyridoxine was effective drug in the treatment of peripheral neuropathic pain in terms of pain relief, safety and cost effectiveness. So it can be an available first line drug before adding other drugs.

• Journal of Yeungnam Medical Science
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• 제36권2호
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• pp.92-98
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• 2019

Forefoot disorders are often seen in clinical practice. Forefoot deformity and pain can deteriorate gait function and decrease quality of life. This review presents common forefoot disorders and conservative treatment using an insole or orthosis. Metatarsalgia is a painful foot condition affecting the metatarsal (MT) region of the foot. A MT pad, MT bar, or forefoot cushion can be used to alleviate MT pain. Hallux valgus is a deformity characterized by medial deviation of the first MT and lateral deviation of the hallux. A toe spreader, valgus splint, and bunion shield are commonly applied to patients with hallux valgus. Hallux limitus and hallux rigidus refer to painful limitations of dorsiflexion of the first metatarsophalangeal joint. A kinetic wedge foot orthosis or rocker sole can help relieve symptoms from hallux limitus or rigidus. Hammer, claw, and mallet toes are sagittal plane deformities of the lesser toes. Toe sleeve or padding can be applied over high-pressure areas in the proximal or distal interphalangeal joints or under the MT heads. An MT off-loading insole can also be used to alleviate symptoms following lesser toe deformities. Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve that leads to a painful condition affecting the MT area. The MT bar, the plantar pad, or a more cushioned insole would be useful. In addition, patients with any of the above various forefoot disorders should avoid tight-fitting or high-heeled shoes. Applying an insole or orthosis and wearing proper shoes can be beneficial for managing forefoot disorders.