Effect of synthetic glucocorticoids on surger y satisfaction in patients with Morton’s neuroma in the practice of a neurosurgeon and orthopedic traumatologist

Morton's neuroma is a benign fibrosis of connective tissue in the metatarsal space caused by local compression and traumatization of the transverse interdigital ligament of the common plantar digital nerve. Up to date there is no consensus on the preferred treatment tactics: there is a large number of studies proving the advantages of conservative techniques, however, many researchers designate surgery as the method of choice. Despite the fact that conservative methods in foreign literature belong to the "non-surgical" group, a number of authors report that conservative methods can cause serious complications and negatively affect the outcome of subsequent surgical treatment. The purpose of the study was to evaluate the effect of injections of synthetic glucocorticoids on the results of surgical treatment in the early and late postoperative periods. Materials and methods: A retrospective-prospective study was conducted on 61 patients undergoing surgical treatment. Based on anamnestic data, the patients were divided into two groups (A and B): the first group (35 patients) included data from patients who initially underwent surgical treatment; the second group (26 patients) had surgical treatment after two injections of synthetic glucocorticoids. A total of 61 patients underwent surgical treatment. Results: We used the Wilcoxon criterion to evaluate the effectiveness of surgical treatment. The obtained p<0.001, at a period of 12 weeks and 12 months from the moment of surgery, indicates a significant improvement after surgical treatment. To compare the two groups of patients, the Mann-Whitney U test was applied; p=0.307 was obtained 12 months after surgery and p=0.613 – 12 weeks after surgery, which indicates that there is no significant statistical difference between the two groups of patients. Conclusion: Although only 7% of patients present active complaints, up to 42% of patients have objective signs of adverse events after injections of synthetic glucocorticoids; however, this type of conservative treatment does not have a significant negative effect on the outcome of surgical treatment.