Effects of 4% Ethanol Sclerosing Injection on Morton's Neuroma: A Histologic Study

Area of Science:

• Podiatric medicine
• Orthopedic surgery
• Neuropathology

Background:

• Controversy exists regarding non-operative treatments for Morton's neuroma.
• Ethanol sclerosing injections show high success rates but their cellular effects are debated.
• Some patients require surgical nerve removal despite non-operative treatments.

Purpose of the Study:

• To evaluate histologic differences in Morton's neuromas after ethanol sclerosing injections versus corticosteroid injections.
• To investigate cellular-level changes in nerve fibers following non-operative treatment for Morton's neuroma.

Main Methods:

• Retrospective histologic review of 23 patients undergoing nerve removal.
• Comparison of patients treated with sclerosing (4% ethanol) versus non-sclerosing (corticosteroid) injections.
• Inclusion criteria applied to 19 patients meeting study parameters.

Main Results:

• Eight patients received sclerosing injections; 11 received non-sclerosing injections.
• Significantly more severe intraneural fibrosis was observed in the non-sclerosing injection group (P = .008).

Conclusions:

• 4% ethanol sclerosing injections induce histologic changes in Morton's neuroma.
• Findings contradict previous studies suggesting sclerosing injections do not alter nerve fibers at a cellular level.