@article{Colò_Rava_Samaila_Palazzolo_Talesa_Schiraldi_Magnan_Ferracini_Felli_2020, title={The effectiveness of shoe modifications and orthotics in the conservative treatment of Civinini-Morton syndrome: state of art}, volume={91}, url={https://mattioli1885journals.com/index.php/actabiomedica/article/view/9713}, DOI={10.23750/abm.v91i4-S.9713}, abstractNote={<p class="p1">Civinini Mo<span class="s1">r</span>t<span class="s3">o</span><span class="s4">n</span><span class="s5">’</span>s <span class="s1">Sy</span>nd<span class="s3">ro</span>me (CMS), better kn<span class="s3">o</span>wn as Mo<span class="s1">r</span>t<span class="s3">o</span><span class="s4">n</span><span class="s5">’</span>s<span class="s3"> N</span>eu<span class="s3">ro</span>ma, is a benign enlargement that <span class="s1">ty</span>pi<span class="s1">c</span>a<span class="s1">ll</span>y affects the thi<span class="s3">r</span>d c<span class="s3">o</span>mm<span class="s3">o</span>n digital b<span class="s1">r</span>an<span class="s1">c</span>h of the plantar ne<span class="s8">r</span>ve. It is a c<span class="s3">o</span>mm<span class="s3">o</span>n <span class="s1">c</span>ause of metatarsalgia leading to debilitating pain. It p<span class="s3">r</span>e<span class="s1">f</span>ers the <span class="s1">f</span>emale gende<span class="s5">r</span>, with a <span class="s1">f</span>emale to male <span class="s1">r</span>atio of 5:1 and an ave<span class="s1">r</span>age age of 50 years at time of surge<span class="s9">r</span><span class="s11">y</span>. <span class="s12">P</span><span class="s3">r</span>ecise<span class="s3"> a</span>etiolo<span class="s9">g</span>y<span class="s3"> r</span>emains under debat<span class="s3">e</span>, with four etiopathogenetic theo<span class="s1">r</span>ies o<span class="s7">f</span>ten cited in the lite<span class="s1">r</span>atu<span class="s3">r</span>e. Clini<span class="s1">c</span>al s<span class="s1">y</span>mpt<span class="s3">o</span>ms, <span class="s3">ph</span><span class="s1">y</span>si<span class="s1">c</span>al exam and inst<span class="s1">r</span>umental <span class="s1">e</span>vidence a<span class="s3">r</span>e important in assessing and g<span class="s1">r</span>ading the disease. Bi<span class="s3">o</span>me<span class="s1">c</span>hanics seem to pl<span class="s3">a</span>y an impo<span class="s1">r</span>tant <span class="s3">r</span>ol<span class="s3">e</span>, especia<span class="s1">ll</span>y <span class="s3">r</span>ega<span class="s3">r</span>ding the usefulness of cor<span class="s3">r</span>ect foo<span class="s1">t</span>wea<span class="s5">r</span>. The first app<span class="s3">r</span>oa<span class="s1">c</span>h in the ea<span class="s7">r</span><span class="s1">l</span>y stages of this c<span class="s3">o</span>nditi<span class="s3">o</span>n usua<span class="s1">ll</span>y begins with shoe modifi<span class="s1">c</span>ati<span class="s3">o</span>ns and o<span class="s1">r</span>thotics, designed to limit the ne<span class="s8">r</span>ve c<span class="s3">o</span>mp<span class="s3">r</span>essi<span class="s3">o</span>n. In o<span class="s3">r</span>der to p<span class="s3">r</span><span class="s1">e</span>vent or del<span class="s3">a</span>y the d<span class="s1">e</span>velo<span class="s3">p</span>ment of CM<span class="s2">S</span>, shoes should be sufficient<span class="s1">l</span>y l<span class="s3">o</span>n<span class="s3">g</span>, c<span class="s3">o</span>mfo<span class="s1">r</span>tabl<span class="s3">e</span>, b<span class="s3">r</span>oad toe-b<span class="s3">ox</span>ed, should bear a flat heel and a sufficient<span class="s1">l</span>y thi<span class="s1">c</span>k exte<span class="s1">r</span>nal sole whi<span class="s1">c</span>h should not be e<span class="s3">x</span>cessive<span class="s1">l</span>y flexible. Most authors suggested that an insole with medial a<span class="s3">r</span><span class="s1">c</span>h suppo<span class="s1">r</span>t and a <span class="s3">r</span>et<span class="s3">r</span>o<span class="s1">c</span>apital bar or pad, just p<span class="s3">ro</span>ximal to the metatarsal heads, displaces the p<span class="s3">r</span>essu<span class="s3">r</span>e sites and <span class="s1">c</span>an be beneficial to <span class="s3">r</span>eli<span class="s1">e</span>ve the pain f<span class="s3">ro</span>m the pin<span class="s1">c</span>hed ne<span class="s8">r</span>ve. A th<span class="s3">r</span>eshold pe<span class="s1">r</span>iod of 4.5 m<span class="s3">o</span>nths appears to emerge f<span class="s3">ro</span>m the <span class="s3">r</span>esults of the ana<span class="s1">ly</span>sed studies, indi<span class="s1">c</span>ating that, b<span class="s1">e</span><span class="s3">yo</span>nd this pe<span class="s1">r</span>iod and in neu<span class="s3">ro</span>mas larger than 5-6 mm, o<span class="s1">r</span>thotics and/or shoes modifi<span class="s1">c</span>ati<span class="s3">o</span>ns do not seem to give c<span class="s3">on</span>vincing <span class="s3">r</span>esults, p<span class="s3">ro</span>ving to be mo<span class="s3">r</span>e a pa<span class="s1">l</span>liati<span class="s3">o</span>n for the <span class="s7">c</span>lini<span class="s1">c</span>al c<span class="s3">o</span>nditi<span class="s3">o</span>n to a<span class="s1">l</span>l<span class="s3">o</span>w an acceptable li<span class="s1">f</span>e with pain <span class="s1">r</span>ather than a <span class="s3">r</span>eal t<span class="s3">r</span>eatment.</p>}, number={4-S}, journal={Acta Biomedica Atenei Parmensis}, author={Colò , Gabriele and Rava, Alessandro and Samaila , Elena Manuela and Palazzolo, Anna and Talesa, Giuseppe and Schiraldi, Marco and Magnan, Bruno and Ferracini , Riccardo and Felli, Lamberto}, year={2020}, month={May}, pages={60–68} }