{"id":4704,"date":"2023-01-28T16:22:58","date_gmt":"2023-01-28T16:22:58","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/physiotherapy-for-mortons-neuroma-fr\/"},"modified":"2023-04-16T20:44:47","modified_gmt":"2023-04-16T20:44:47","slug":"physiotherapy-for-mortons-neuroma-fr","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/fr\/physiotherapy-for-mortons-neuroma-fr\/","title":{"rendered":"Physioth\u00e9rapie pour le n\u00e9vrome de Morton"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\"><b>\u00c9diteur original<\/b> &#8211; <a title=\"User:Ewa Jaraczewska\" href=\"\/User:Ewa_Jaraczewska\">Ewa Jaraczewska<\/a><br \/>\n<b>Principaux contributeurs<\/b> &#8211; <a class=\"mw-userlink\" title=\"User:Ewa Jaraczewska\" href=\"\/User:Ewa_Jaraczewska\"><bdi>Ewa Jaraczewska<\/bdi><\/a> et <a class=\"mw-userlink\" title=\"User:Jess Bell\" href=\"\/User:Jess_Bell\"><bdi>Jess Bell<\/bdi><\/a><\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display: none;\" role=\"button\" type=\"checkbox\"><\/p>\n<div class=\"toctitle\" dir=\"ltr\" lang=\"en\">\n<h2 id=\"mw-toc-heading\">Contenu<\/h2>\n<\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#Introduction\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">Introduction<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Clinically_Relevant_Anatomy\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">Anatomie cliniquement pertinente<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-3\"><a href=\"#Neuroma\"><span class=\"tocnumber\">2.1<\/span> <span class=\"toctext\">Le n\u00e9vrome<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-4\"><a href=\"#Aetiology\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">\u00c9tiologie<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-5\"><a href=\"#Epidemiology\"><span class=\"tocnumber\">3.1<\/span> <span class=\"toctext\">\u00c9pid\u00e9miologie<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-6\"><a href=\"#Mechanism_of_Injury_.2F_Pathological_Process\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">M\u00e9canisme de la l\u00e9sion \/ Processus pathologique<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-7\"><a href=\"#Clinical_Presentation\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">Pr\u00e9sentation clinique<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-8\"><a href=\"#Diagnostic_Tests\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">Tests diagnostiques<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-9\"><a href=\"#Diagnostic_Procedures\"><span class=\"tocnumber\">7<\/span> <span class=\"toctext\">Proc\u00e9dures diagnostiques<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-10\"><a href=\"#Differential_Diagnosis\"><span class=\"tocnumber\">8<\/span> <span class=\"toctext\">Diagnostic diff\u00e9rentiel<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-11\"><a href=\"#Physiotherapy_Management_.2F_Interventions\"><span class=\"tocnumber\">9<\/span> <span class=\"toctext\">Traitement \/ interventions en physioth\u00e9rapie<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-12\"><a href=\"#Footwear\"><span class=\"tocnumber\">9.1<\/span> <span class=\"toctext\">Les chaussures<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-13\"><a href=\"#Patient_Education\"><span class=\"tocnumber\">9.1.1<\/span> <span class=\"toctext\">\u00c9ducation des patients<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-14\"><a href=\"#Footwear_Modification\"><span class=\"tocnumber\">9.1.2<\/span> <span class=\"toctext\">Modification des chaussures<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-2 tocsection-15\"><a href=\"#Orthotics\"><span class=\"tocnumber\">9.2<\/span> <span class=\"toctext\">Les orth\u00e8ses<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-16\"><a href=\"#Steroid_Injections\"><span class=\"tocnumber\">9.3<\/span> <span class=\"toctext\">Les injections de st\u00e9ro\u00efdes<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-17\"><a href=\"#Modality\"><span class=\"tocnumber\">9.4<\/span> <span class=\"toctext\">Modalit\u00e9s<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-18\"><a href=\"#Manipulation.2FMobilisation\"><span class=\"tocnumber\">9.5<\/span> <span class=\"toctext\">Manipulation \/ Mobilisation<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-19\"><a href=\"#Strengthening_Exercises\"><span class=\"tocnumber\">9.6<\/span> <span class=\"toctext\">Exercices de renforcement<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-20\"><a href=\"#Other_Treatment_Options\"><span class=\"tocnumber\">10<\/span> <span class=\"toctext\">Autres options de traitement<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-21\"><a href=\"#Resources\"><span class=\"tocnumber\">11<\/span> <span class=\"toctext\">Ressources<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-22\"><a href=\"#References\"><span class=\"tocnumber\">12<\/span> <span class=\"toctext\">R\u00e9f\u00e9rences<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span id=\"Introduction\" class=\"mw-headline\">Introduction<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Introduction\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=1\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Introduction\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=1\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Le syndrome de compression du nerf interdigital est plus commun\u00e9ment appel\u00e9 n\u00e9vrome de Morton. Weinfield et Myerson <sup id=\"cite_ref-1\" class=\"reference\"><a href=\"#cite_note-1\">(1)<\/a><\/sup> ont \u00e9galement propos\u00e9 le terme \u00ab\u00a0n\u00e9vrite interdigitale\u00a0\u00bb, qui d\u00e9crit mieux la pathologie de cette affection. La d\u00e9g\u00e9n\u00e9rescence neurale et la fibrose p\u00e9rineurale sont typiques du n\u00e9vrome de Morton. <sup id=\"cite_ref-2\" class=\"reference\"><a href=\"#cite_note-2\">(2)<\/a><\/sup>; la pr\u00e9sence de tissu inflammatoire \u00e0 l&rsquo;examen histologique justifie la description du n\u00e9vrome de Morton comme une fibrose p\u00e9rineurale. <sup id=\"cite_ref-:10_3-0\" class=\"reference\"><a href=\"#cite_note-:10-3\">(3)<\/a><\/sup> Les sympt\u00f4mes cliniques pouvant aider au diagnostic sont la douleur et une sensation anormale au niveau de l&rsquo;avant-pied. Le traitement conservateur, y compris l&rsquo;adaptation du mode de vie, n&rsquo;est pas toujours pratique. Ainsi, les patients peuvent choisir d&rsquo;avoir recours \u00e0 la chirurgie ou \u00e0 diff\u00e9rents types d&rsquo;injections percutan\u00e9es guid\u00e9 par \u00e9chographie pour traiter cette affection.<\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Foot_Inneravtion.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/6\/69\/Foot_Inneravtion.gif\/300px-Foot_Inneravtion.gif\" srcset=\"https:\/\/www.physio-pedia.com\/images\/6\/69\/Foot_Inneravtion.gif 1.5x\" alt=\"\" width=\"300\" height=\"323\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Innervation du pied<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h2><span id=\"Clinically_Relevant_Anatomy\" class=\"mw-headline\">Anatomie cliniquement pertinente <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinically Relevant Anatomy\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=2\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Clinically Relevant Anatomy\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=2\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>L&rsquo;imagerie par r\u00e9sonance magn\u00e9tique (IRM) montre que les <a title=\"Medial Plantar Nerve\" href=\"\/Medial_Plantar_Nerve\">nerfs plantaires m\u00e9dial<\/a> et <a title=\"Lateral Plantar Nerve\" href=\"\/Lateral_Plantar_Nerve\">lat\u00e9ral<\/a> naissent du <a title=\"Tibial Nerve\" href=\"\/Tibial_Nerve\">nerf tibial<\/a> post\u00e9rieur.<sup id=\"cite_ref-:7_4-0\" class=\"reference\"><a href=\"#cite_note-:7-4\">(4)<\/a><\/sup> Une bifurcation du nerf tibial se produit \u00e0 l&rsquo;int\u00e9rieur ou \u00e0 proximit\u00e9 du r\u00e9tinaculum des fl\u00e9chisseurs.<sup id=\"cite_ref-:8_5-0\" class=\"reference\"><a href=\"#cite_note-:8-5\">(5)<\/a><\/sup> Les deux nerfs plantaires p\u00e9n\u00e8trent dans le tunnel compos\u00e9 par l&rsquo;apon\u00e9vrose profonde du <a title=\"Abductor Hallucis\" href=\"\/Abductor_Hallucis\">muscle abducteur de l&rsquo;hallux<\/a> et le septum fibreux, qui relie l&rsquo;apon\u00e9vrose \u00e0 l&rsquo;os.<sup id=\"cite_ref-:8_5-1\" class=\"reference\"><a href=\"#cite_note-:8-5\">(5)<\/a><\/sup><\/p>\n<p>Le <a title=\"Medial Plantar Nerve\" href=\"\/Medial_Plantar_Nerve\">nerf plantaire m\u00e9dial<\/a> est le plus grand des deux nerfs plantaires. Il prend naissance sous le r\u00e9tinaculum des fl\u00e9chisseurs (\u00e9galement connu sous le nom de ligament laciniate) et passe entre l&rsquo;<a title=\"Abductor Hallucis\" href=\"\/Abductor_Hallucis\">abducteur de l&rsquo;hallux<\/a> et le <a title=\"Flexor Digitorum Brevis\" href=\"\/Flexor_Digitorum_Brevis\">court fl\u00e9chisseur des orteils<\/a>. En atteignant les bases m\u00e9tatarsiennes, il se divise en trois nerfs digitaux plantaires communs <sup id=\"cite_ref-:9_6-0\" class=\"reference\"><a href=\"#cite_note-:9-6\">(6)<\/a><\/sup> aussi appel\u00e9s plantaires interdigitaux communs. Le nerf plantaire m\u00e9dial innerve l&rsquo;abducteur de l&rsquo;hallux, le <a title=\"Flexor Hallucis Brevis\" href=\"\/Flexor_Hallucis_Brevis\">court fl\u00e9chisseur de l&rsquo;hallux<\/a>, le court fl\u00e9chisseur des orteils et le premier muscle lombrical du pied.<\/p>\n<p>Le <a title=\"Lateral Plantar Nerve\" href=\"\/Lateral_Plantar_Nerve\">nerf plantaire lat\u00e9ral<\/a> innerve l&rsquo;<a title=\"Abductor Digiti Minimi (Foot)\" href=\"\/Abductor_Digiti_Minimi_(Foot)\">abducteur du 5e orteil<\/a>, le <a title=\"Flexor Digiti Minimi Brevis\" href=\"\/Flexor_Digiti_Minimi_Brevis\">court fl\u00e9chisseur du 5e orteil<\/a>, le <a title=\"Le carr\u00e9 plantaire\" href=\"\/Quadratus_Plantae\">muscle carr\u00e9 plantaire<\/a>, les trois lombricaux lat\u00e9raux du pied, l&rsquo;<a title=\"Adductor Hallucis\" href=\"\/Adductor_Hallucis\">adducteur de l&rsquo;hallux<\/a>, les interosseux plantaires et les <a title=\"Dorsal Interossei of the Foot\" href=\"\/Dorsal_Interossei_of_the_Foot\">interosseux dorsaux<\/a>.<\/p>\n<p>Les nerfs digitaux plantaires communs (ou interdigitaux communs) passent sous les ligaments interm\u00e9tatarsiens. Ils passent \u00e0 travers l&rsquo;<a title=\"Aponeurosis\" href=\"\/Aponeurosis\">apon\u00e9vrose<\/a> plantaire et se divisent en deux branches, qui alimentent la peau plantaire des orteils. De plus petites portions des nerfs digitaux plantaires communs innervent les <a title=\"Metatarsals\" href=\"\/Metatarsals\">m\u00e9tatarsiens<\/a> adjacents, les articulations m\u00e9tatarso-phalangiennes et la peau plantaire sous les t\u00eates m\u00e9tatarsiennes. <sup id=\"cite_ref-:5_7-0\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/p>\n<p>Le <i>troisi\u00e8me nerf digital commun<\/i> (aussi appel\u00e9 interdigital commun) part du nerf plantaire m\u00e9dial et re\u00e7oit une branche communicante du nerf plantaire lat\u00e9ral. Parce qu&rsquo;il passe dans l&rsquo;espace \u00e9troit situ\u00e9 en profondeur du ligament m\u00e9tatarsien transverse, il devient moins mobile, notamment lors des activit\u00e9s en mise en charge.<sup id=\"cite_ref-:5_7-1\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/p>\n<p>Les branches du nerf digital commun dans le troisi\u00e8me espace interm\u00e9tatarsien sont le plus souvent touch\u00e9es dans le n\u00e9vrome de Morton. Il a \u00e9t\u00e9 propos\u00e9 que l&#8217;emplacement de ce nerf (dans l&rsquo;espace \u00e9troit du ligament m\u00e9tatarsien transverse) puisse expliquer pourquoi le n\u00e9vrome de Morton se produit souvent dans le troisi\u00e8me espace interm\u00e9tatarsien.<sup id=\"cite_ref-:5_7-2\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Mortons-neuroma-1.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/4b\/Mortons-neuroma-1.gif\/300px-Mortons-neuroma-1.gif\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/4b\/Mortons-neuroma-1.gif\/450px-Mortons-neuroma-1.gif 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/4\/4b\/Mortons-neuroma-1.gif\/600px-Mortons-neuroma-1.gif 2x\" alt=\"\" width=\"300\" height=\"225\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>N\u00e9vrome de Morton<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h3><span id=\"Neuroma\" class=\"mw-headline\">Le n\u00e9vrome<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Neuroma\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=3\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Neuroma\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=3\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Un n\u00e9vrome est \u00e9galement appel\u00e9 un nerf pinc\u00e9. Le n\u00e9vrome de Morton est une neuropathie compressive du nerf digital plantaire commun caus\u00e9e par un coincement du nerf entre les ligaments interm\u00e9tatarsiens.<\/p>\n<h2><span id=\"Aetiology\" class=\"mw-headline\">\u00c9tiologie<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Aetiology\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=4\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Aetiology\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=4\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Il existe plusieurs th\u00e9ories \u00e9tiopathog\u00e9n\u00e9tiques \u00e0 l&rsquo;origine du d\u00e9veloppement du n\u00e9vrome de Morton. Elles incluent :<\/p>\n<ul>\n<li>Un dommage chronique par traction <sup id=\"cite_ref-:6_8-0\" class=\"reference\"><a href=\"#cite_note-:6-8\">(8)<\/a><\/sup><\/li>\n<li>Un traumatisme chronique et r\u00e9p\u00e9titif <sup id=\"cite_ref-:6_8-1\" class=\"reference\"><a href=\"#cite_note-:6-8\">(8)<\/a><\/sup><\/li>\n<li>Une isch\u00e9mie des vasa nervorum (Vasa nervorum = vaisseaux nutritifs qui assurent l&rsquo;approvisionnement en sang de chaque nerf p\u00e9riph\u00e9rique \u00e0 partir des vaisseaux sanguins adjacents) <sup id=\"cite_ref-:5_7-3\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7) <\/a><\/sup><sup id=\"cite_ref-:6_8-2\" class=\"reference\"><a href=\"#cite_note-:6-8\">(8)<\/a><\/sup><\/li>\n<li>Un pi\u00e9geage ou une compression m\u00e9canique <sup id=\"cite_ref-:10_3-1\" class=\"reference\"><a href=\"#cite_note-:10-3\">(3) <\/a><\/sup><sup id=\"cite_ref-:0_9-0\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup><\/li>\n<li>Une inflammation due \u00e0 une bursite interm\u00e9tatarsienne <sup id=\"cite_ref-:10_3-2\" class=\"reference\"><a href=\"#cite_note-:10-3\">(3)<\/a><\/sup><\/li>\n<\/ul>\n<p><b>Consid\u00e9rations anatomiques :<\/b><\/p>\n<ul>\n<li>Le troisi\u00e8me nerf digital commun est plus \u00e9pais que les autres en raison d&rsquo;une anastomose entre deux troncs nerveux <sup id=\"cite_ref-:5_7-4\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/li>\n<li>Le quatri\u00e8me rayon est plus mobile que le troisi\u00e8me, ce qui peut entra\u00eener une inflammation <sup id=\"cite_ref-:5_7-5\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/li>\n<li>Le nerf plantaire est comprim\u00e9 par le ligament m\u00e9tatarsien transverse distal <sup id=\"cite_ref-:10_3-3\" class=\"reference\"><a href=\"#cite_note-:10-3\">(3)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span id=\"Epidemiology\" class=\"mw-headline\">\u00c9pid\u00e9miologie<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Epidemiology\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=5\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Epidemiology\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=5\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Les femmes sont plus nombreuses que les hommes \u00e0 d\u00e9velopper un n\u00e9vrome de Morton, avec un rapport femmes-hommes de 5:1. <sup id=\"cite_ref-:5_7-6\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup> Il touche environ 30 % de la population. L&rsquo;\u00e2ge moyen pour le dveloppement d&rsquo;un n\u00e9vrome de Morton est de 50 ans. Il touche les deux pieds, et dans la plupart des cas, le troisi\u00e8me espace interm\u00e9tatarsien est concern\u00e9, suivi du deuxi\u00e8me (n\u00e9vrome de Hauser). <sup id=\"cite_ref-:1_10-0\" class=\"reference\"><a href=\"#cite_note-:1-10\">(10)<\/a><\/sup> Les localisations multiples sont rares. <sup id=\"cite_ref-:5_7-7\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/p>\n<h2><span id=\"Mechanism_of_Injury_\/_Pathological_Process\"><\/span><span id=\"Mechanism_of_Injury_.2F_Pathological_Process\" class=\"mw-headline\">M\u00e9canisme de la l\u00e9sion \/ Processus pathologique <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Mechanism of Injury \/ Pathological Process\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=6\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Mechanism of Injury \/ Pathological Process\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=6\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Selon la litt\u00e9rature, le m\u00e9canisme de l\u00e9sion le plus fr\u00e9quent est le coincement des nerfs.<sup id=\"cite_ref-:0_9-1\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup> Comme le troisi\u00e8me nerf digital commun est plus \u00e9pais en raison de la fusion des nerfs plantaires m\u00e9dial et lat\u00e9ral, il peut \u00eatre coinc\u00e9 par le ligament environnant.<sup id=\"cite_ref-:0_9-2\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup> Ainsi, la neuropathie par compression provoque une fibrose p\u00e9rineurale et une d\u00e9g\u00e9n\u00e9rescence nerveuse.<sup id=\"cite_ref-:0_9-3\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup> L&rsquo;\u00e9paississement du nerf progresse en raison de la hyalinisation vasculaire, ce qui provoque davantage de traumatismes et de coincement du nerf. Le port de chaussures \u00e0 talons hauts peut \u00e9galement aggraver le processus pathologique, car ces chaussures entra\u00eenent une mise en charge excessive sur l&rsquo;avant-pied.<sup id=\"cite_ref-:0_9-4\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup><\/p>\n<h2><span id=\"Clinical_Presentation\" class=\"mw-headline\">Pr\u00e9sentation clinique <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinical Presentation\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=7\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Clinical Presentation\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=7\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Les personnes atteintes du n\u00e9vrome de Morton peuvent \u00eatre cliniquement symptomatiques ou asymptomatiques. Les personnes atteintes d&rsquo;un n\u00e9vrome de Morton cliniquement symptomatique peuvent pr\u00e9senter les sympt\u00f4mes suivants : <sup id=\"cite_ref-:0_9-5\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup><\/p>\n<ul>\n<li>Douleur ou paresth\u00e9sie dans la r\u00e9gion interm\u00e9tatarsienne et les orteils correspondantes La douleur est aggrav\u00e9e par la mise en charge ou l&rsquo;utilisation de chaussures \u00e0 talons hauts Enlever les chaussures et masser doucement l&rsquo;avant-pied peut g\u00e9n\u00e9ralement soulager la douleur<\/li>\n<li>La douleur est g\u00e9n\u00e9ralement vive et peut devenir d\u00e9bilitante au point que le patient a peur ou est anxieux \u00e0 l&rsquo;id\u00e9e de marcher ou m\u00eame de poser le pied au sol<sup id=\"cite_ref-:5_7-8\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/li>\n<li>Le patient peut se plaindre d&rsquo;une sensation de br\u00fblure dans les espaces interm\u00e9tatarsiens<sup id=\"cite_ref-:11_11-0\" class=\"reference\"><a href=\"#cite_note-:11-11\">(11)<\/a><\/sup><\/li>\n<li>Une masse peut \u00eatre palp\u00e9e<\/li>\n<li>Les sympt\u00f4mes peuvent \u00eatre pr\u00e9sents \u00e0 la suite d&rsquo;un traumatisme<\/li>\n<li>Les patients peuvent d\u00e9crire une alt\u00e9ration de la sensation et dire qu&rsquo;ils ont l&rsquo;impression d&rsquo;avoir un \u00ab\u00a0caillou dans la chaussure\u00a0\u00bb<sup id=\"cite_ref-:2_12-0\" class=\"reference\"><a href=\"#cite_note-:2-12\">(12)<\/a><\/sup><\/li>\n<li>La douleur s&rsquo;aggrave \u00e0 la marche ou la course<sup id=\"cite_ref-:2_12-1\" class=\"reference\"><a href=\"#cite_note-:2-12\">(12)<\/a><\/sup><\/li>\n<\/ul>\n<p>La pr\u00e9sence d&rsquo;un <a title=\"L'hallux valgus\" href=\"\/Hallux_Valgus\">hallux valgus<\/a> est consid\u00e9r\u00e9e comme un facteur pr\u00e9disposant au d\u00e9veloppement du n\u00e9vrome de Morton <sup id=\"cite_ref-:2_12-2\" class=\"reference\"><a href=\"#cite_note-:2-12\">(12)<\/a><\/sup><\/p>\n<h2><span id=\"Diagnostic_Tests\" class=\"mw-headline\">Tests diagnostiques <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Diagnostic Tests\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=8\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Diagnostic Tests\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=8\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ul>\n<li><a title=\"Metatarsal Squeeze Test\" href=\"\/Metatarsal_Squeeze_Test\">Le test de compression de l&rsquo;espace m\u00e9tatarsien<\/a> (\u00e9galement connu sous le nom de metatarsal squeeze test) : Le clinicien saisit les faces m\u00e9diale et lat\u00e9rale de l&rsquo;avant-pied du patient et les comprime d&rsquo;une main tandis que l&rsquo;autre main palpe la zone sensible. L&rsquo;aggravation de la douleur indique un test positif.<\/li>\n<li>Le signe de Mulder : un clic douloureux et palpable <sup id=\"cite_ref-13\" class=\"reference\"><a href=\"#cite_note-13\">(13)<\/a><\/sup> qui se produit lors d&rsquo;une pression sur un n\u00e9vrome ou le frottement de celui-ci entre les t\u00eates m\u00e9tatarsiennes.<\/li>\n<li>Le test d&rsquo;\u00e9tirement du nerf digital <sup id=\"cite_ref-14\" class=\"reference\"><a href=\"#cite_note-14\">(14) <\/a><\/sup>: Le clinicien maintient passivement les deux chevilles en dorsiflexion compl\u00e8te et am\u00e8ne en extension compl\u00e8te passive les orteils adjacentes \u00e0 l&rsquo;espace interm\u00e9tatarsien suspect\u00e9. Le test est positif si le patient se plaint d&rsquo;une g\u00eane ou inconfort dans l&rsquo;espace interm\u00e9tatarsien du pied affect\u00e9.<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/yJ7LUCCmFAU?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-15\" class=\"reference\"><a href=\"#cite_note-15\">(15)<\/a><\/sup><\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Morton%27s-MRI.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/8\/87\/Morton%27s-MRI.png\/300px-Morton%27s-MRI.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/8\/87\/Morton%27s-MRI.png 1.5x\" alt=\"\" width=\"300\" height=\"239\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>IRM du n\u00e9vrome de Morton<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Morton%27s-Xray.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/2\/25\/Morton%27s-Xray.png\/300px-Morton%27s-Xray.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/2\/25\/Morton%27s-Xray.png 1.5x\" alt=\"\" width=\"300\" height=\"216\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Radiographie du n\u00e9vrome de Morton<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Morton%27s-US.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/a\/a3\/Morton%27s-US.png\/300px-Morton%27s-US.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/a\/a3\/Morton%27s-US.png 1.5x\" alt=\"\" width=\"300\" height=\"264\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>\u00c9chographie du n\u00e9vrome de Morton<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h2><span id=\"Diagnostic_Procedures\" class=\"mw-headline\">Proc\u00e9dures de diagnostic <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Diagnostic Procedures\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=9\">modifier<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Diagnostic Procedures\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=9\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ul>\n<li>\u00c9chographie : pr\u00e9cision diagnostique \u00e9lev\u00e9e. Le bon diagnostic d\u00e9pend de la technique et de l&rsquo;exp\u00e9rience de la personne qui effectue le test <sup id=\"cite_ref-:5_7-9\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7) <\/a><\/sup><sup id=\"cite_ref-:1_10-1\" class=\"reference\"><a href=\"#cite_note-:1-10\">(10)<\/a><\/sup><\/li>\n<li>Imagerie par r\u00e9sonance magn\u00e9tique (IRM) : l&rsquo;examen de r\u00e9f\u00e9rence pour identifier un neurinome. <sup id=\"cite_ref-:2_12-3\" class=\"reference\"><a href=\"#cite_note-:2-12\">(12)<\/a><\/sup> Les indications primaires de l&rsquo;IRM sont une \u00e9valuation clinique peu claire et les cas o\u00f9 plus d&rsquo;un espace interm\u00e9tatarsien est affect\u00e9 <sup id=\"cite_ref-:5_7-10\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/li>\n<li>Radiographies : essentielles en tant qu&rsquo;approche d&rsquo;imagerie de premi\u00e8re ligne pour exclure la raideur de l&rsquo;articulation tarso-m\u00e9tatarsienne, l&rsquo;hyperm\u00e9trie m\u00e9tatarsienne, la maladie de Frieberg, les d\u00e9formations des orteils et les instabilit\u00e9s m\u00e9tatarso-phalangiennes.<\/li>\n<\/ul>\n<h2><span id=\"Differential_Diagnosis\" class=\"mw-headline\">Diagnostic diff\u00e9rentiel <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Differential Diagnosis\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=10\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Differential Diagnosis\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=10\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Le diagnostic diff\u00e9rentiel inclut les conditions suivantes : <sup id=\"cite_ref-:0_9-6\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup><\/p>\n<ul>\n<li>Bursite interm\u00e9tatarsienne<\/li>\n<li>V\u00e9ritable n\u00e9vrome<\/li>\n<li>Arthrite inflammatoire<\/li>\n<li><a title=\"Pigmeted Villonodular Synovitis\" href=\"\/Pigmeted_Villonodular_Synovitis\">Synovite villonodulaire pigment\u00e9e<\/a><\/li>\n<li><a title=\"Ost\u00e9omy\u00e9lite\" href=\"\/Osteomyelitis\">Ost\u00e9omy\u00e9lite<\/a><\/li>\n<li>Granulome \u00e0 corps \u00e9tranger<\/li>\n<li><a title=\"Stress Fractures\" href=\"\/Stress_Fractures\">Fracture de stress<\/a><\/li>\n<li>Maladie de Freiberg (Infraction de Freiberg)<\/li>\n<li>Dislocation de l&rsquo;articulation m\u00e9tatarso-phalangienne<\/li>\n<\/ul>\n<h2><span id=\"Physiotherapy_Management_\/_Interventions\"><\/span><span id=\"Physiotherapy_Management_.2F_Interventions\" class=\"mw-headline\">Traitement \/ Interventions en physioth\u00e9rapie <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Physiotherapy Management \/ Interventions\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=11\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Physiotherapy Management \/ Interventions\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=11\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<h3><span id=\"Footwear\" class=\"mw-headline\">Les chaussures<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Footwear\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=12\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Footwear\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=12\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Objectif : limiter la compression nerveuse dans les premiers stades du n\u00e9vrome de Morton.<\/p>\n<p>Outils : \u00e9ducation du patient, modification des chaussures.<\/p>\n<blockquote><p>Selon Col\u00f2 et al, <sup id=\"cite_ref-:5_7-11\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup> si un individu est \u00e0 plus de 4,5 mois apr\u00e8s le diagnostic et que le n\u00e9vrome est plus grand que 5-6 mm, les orth\u00e8ses et\/ou les modifications de chaussures ne sont plus efficaces pour g\u00e9rer les sympt\u00f4mes. \u00c0 ce stade, ils offrent une solution palliative pour parvenir \u00e0 une <i>\u00ab\u00a0vie acceptable avec la douleur<\/i>\u00ab\u00a0. <sup id=\"cite_ref-:5_7-12\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/p><\/blockquote>\n<h4><span id=\"Patient_Education\" class=\"mw-headline\">\u00c9ducation des patients <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Patient Education\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=13\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Patient Education\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=13\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>Le patient doit recevoir une \u00e9ducation sur :<\/p>\n<ul>\n<li>\u00c9viter les chaussures \u00e9troites et \u00e0 talons hauts<\/li>\n<li>Respecter la prescription de chaussures<\/li>\n<li>Modifier ses activit\u00e9s <sup id=\"cite_ref-:13_16-0\" class=\"reference\"><a href=\"#cite_note-:13-16\">(16)<\/a><\/sup><\/li>\n<\/ul>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Rocker_sole_shoe.jpeg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/b\/b1\/Rocker_sole_shoe.jpeg\/300px-Rocker_sole_shoe.jpeg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/b\/b1\/Rocker_sole_shoe.jpeg 1.5x\" alt=\"\" width=\"300\" height=\"301\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Chaussure \u00e0 semelle berceau<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h4><span id=\"Footwear_Modification\" class=\"mw-headline\">Modification des chaussures <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Footwear Modification\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=14\">modifier<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Footwear Modification\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=14\">modifier la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>Les chaussures les plus appropri\u00e9es auront les caract\u00e9ristiques suivantes : <sup id=\"cite_ref-:5_7-13\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7) <\/a><\/sup><sup id=\"cite_ref-:3_17-0\" class=\"reference\"><a href=\"#cite_note-:3-17\">(17)<\/a><\/sup><\/p>\n<ul>\n<li>Suffisamment longues <sup id=\"cite_ref-:5_7-14\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/li>\n<li>Partie des orteils large <sup id=\"cite_ref-:5_7-15\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/li>\n<li>Talon bas <sup id=\"cite_ref-:5_7-16\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/li>\n<li>Semelle ext\u00e9rieure \u00e9paisse, qui ne doit pas \u00eatre excessivement flexible <sup id=\"cite_ref-:5_7-17\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/li>\n<li>Rembourr\u00e9e au niveau du m\u00e9tatarse <sup id=\"cite_ref-:3_17-1\" class=\"reference\"><a href=\"#cite_note-:3-17\">(17)<\/a><\/sup><\/li>\n<li>Une semelle berceau pourrait \u00eatre utile <sup id=\"cite_ref-18\" class=\"reference\"><a href=\"#cite_note-18\">(18)<\/a><\/sup><\/li>\n<\/ul>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/93\/Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg\/300px-Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/93\/Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg\/450px-Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/9\/93\/Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg\/600px-Metatarsal_Pad_-_Shutterstock_Image_-_ID_1603933129.jpg 2x\" alt=\"\" width=\"300\" height=\"300\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Coussinet m\u00e9tatarsien<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h3><span id=\"Orthotics\" class=\"mw-headline\">Les orth\u00e8ses<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Orthotics\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=15\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Orthotics\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=15\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Objectifs :<\/p>\n<ol>\n<li>Dispercer les sites de pression<\/li>\n<li>Soulager la douleur<\/li>\n<\/ol>\n<ul>\n<li>L&rsquo;orth\u00e8se la plus courante fournie initialement est la <b>barre m\u00e9tatarsienne<\/b>. Elle vise \u00e0 :\n<ul>\n<li>\u00c9cartez les t\u00eates des m\u00e9tatarses pour soulager la pression<\/li>\n<li>Am\u00e9liorer les sympt\u00f4mes<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Il y a peu ou pas de preuves d&rsquo;une am\u00e9lioration des r\u00e9sultats rapport\u00e9s par les patients avec l&rsquo;utilisation de <i>semelles d&rsquo;inversion ou d&rsquo;\u00e9version<\/i> (cale-pied varus\/valgus). <sup id=\"cite_ref-:2_12-4\" class=\"reference\"><a href=\"#cite_note-:2-12\">(12)<\/a><\/sup><\/li>\n<\/ul>\n<ul>\n<li>Selon de Oliveira et al, <sup id=\"cite_ref-:12_19-0\" class=\"reference\"><a href=\"#cite_note-:12-19\">(19)<\/a><\/sup> une <b>semelle personnalis\u00e9e avec un support du m\u00e9tatarse et de l&rsquo;arche plantaire <\/b> soulage la douleur pendant la marche et am\u00e9liore la fonction.<\/li>\n<li>Des <b>semelles int\u00e9rieures d&rsquo;orteil sur mesure<\/b> model\u00e9es en caoutchouc de silicone peuvent \u00eatre ajout\u00e9es en cas de pr\u00e9sence de d\u00e9formation en griffe ou marteau des orteils. <sup id=\"cite_ref-:0_9-7\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup><\/li>\n<li>Orth\u00e8ses sur mesure gr\u00e2ce aux <b>m\u00e9thodes d&rsquo;impression sur mousse<\/b> : le pied est plac\u00e9 dans une position sous-talienne neutre, avec une arche longitudinale prolong\u00e9e pour soutenir le premier m\u00e9tatarsien (appui plat). L&rsquo;objectif est d&rsquo;imiter le sch\u00e9ma physiologique de l&rsquo;appui sur le m\u00e9tatarse, de l&rsquo;ext\u00e9rieur vers l&rsquo;int\u00e9rieur, avant que la pression ne se d\u00e9place vers le gros orteil.<sup id=\"cite_ref-:5_7-18\" class=\"reference\"><a href=\"#cite_note-:5-7\">(7)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span id=\"Steroid_Injections\" class=\"mw-headline\">Les injections de st\u00e9ro\u00efdes <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Steroid Injections\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=16\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Steroid Injections\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=16\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Objectif : soulager la douleur.<\/p>\n<p>Les injections de st\u00e9ro\u00efdes sont assez classiques dans le traitement du n\u00e9vrome de Morton. La m\u00e9thode d&rsquo;injection varie : elle peut \u00eatre guid\u00e9e par \u00e9chographie ou par une technique de rep\u00e9rage.<\/p>\n<ul>\n<li>Un essai contr\u00f4l\u00e9 randomis\u00e9 r\u00e9alis\u00e9 par Mahadevan et al. <sup id=\"cite_ref-20\" class=\"reference\"><a href=\"#cite_note-20\">(20)<\/a><\/sup> n&rsquo;a trouv\u00e9 aucune diff\u00e9rence statistique dans les r\u00e9sultats des patients apr\u00e8s une injection de st\u00e9ro\u00efdes guid\u00e9e par \u00e9chographie par rapport \u00e0 une injection non guid\u00e9e par \u00e9chographie<\/li>\n<li>Choi et al. <sup id=\"cite_ref-:15_21-0\" class=\"reference\"><a href=\"#cite_note-:15-21\">(21)<\/a><\/sup> ont d\u00e9montr\u00e9 qu&rsquo;il y avait un \u00ab\u00a0r\u00e9sultat clinique satisfaisant\u00a0\u00bb <sup id=\"cite_ref-:15_21-1\" class=\"reference\"><a href=\"#cite_note-:15-21\">(21)<\/a><\/sup> en termes de r\u00e9duction de la douleur chez les patients apr\u00e8s des injections de corticost\u00e9ro\u00efdes, mais 30 % des patients ont finalement d\u00fb subir une intervention chirurgicale pour g\u00e9rer la douleur<\/li>\n<li>Lizano-Diez et al. <sup id=\"cite_ref-22\" class=\"reference\"><a href=\"#cite_note-22\">(22)<\/a><\/sup> n&rsquo;ont trouv\u00e9 aucune diff\u00e9rence en termes de douleur et de fonction chez les participants ayant re\u00e7u une injection de corticost\u00e9ro\u00efde plus un anesth\u00e9sique local par rapport \u00e0 ceux ayant re\u00e7u uniquement un anesth\u00e9sique local<\/li>\n<\/ul>\n<h3><span id=\"Modality\" class=\"mw-headline\">Modalit\u00e9s<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Modality\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=17\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Modality\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=17\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<ul>\n<li>La <a title=\"Extracorporeal Shockwave Therapy (ESWT)\" href=\"\/Extracorporeal_Shockwave_Therapy_(ESWT)\">th\u00e9rapie extracorporelle par ondes de choc <\/a><sup id=\"cite_ref-:4_23-0\" class=\"reference\"><a href=\"#cite_note-:4-23\">(23)<\/a><\/sup> peut r\u00e9duire la douleur chez les patients atteints du n\u00e9vrome de Morton <sup id=\"cite_ref-:4_23-1\" class=\"reference\"><a href=\"#cite_note-:4-23\">(23)<\/a><\/sup><\/li>\n<li>La <a title=\"Transcutaneous Electrical Nerve Stimulation (TENS)\" href=\"\/Transcutaneous_Electrical_Nerve_Stimulation_(TENS)\">stimulation \u00e9lectrique transcutan\u00e9e (TENS)<\/a> peut contribuer \u00e0 la gestion de la douleur <sup id=\"cite_ref-:13_16-1\" class=\"reference\"><a href=\"#cite_note-:13-16\">(16)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span id=\"Manipulation\/Mobilisation\"><\/span><span id=\"Manipulation.2FMobilisation\" class=\"mw-headline\">Manipulation \/ Mobilisation<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Manipulation\/Mobilisation\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=18\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Manipulation\/Mobilisation\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=18\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Selon Cashley et Cochrane, <sup id=\"cite_ref-:14_24-0\" class=\"reference\"><a href=\"#cite_note-:14-24\">(24)<\/a><\/sup> la manipulation du pied et la mobilisation des articulations du pied et de la cheville peuvent diminuer la douleur du pied chez les patients diagnostiqu\u00e9s avec une n\u00e9vralgie digitale plantaire (n\u00e9vrome de Morton). Les auteurs recommandent d&rsquo;effectuer une manipulation articulaire une fois par semaine pendant quatre semaines, suivie de deux autres visites \u00e0 14 jours d&rsquo;intervalle.<sup id=\"cite_ref-:14_24-1\" class=\"reference\"><a href=\"#cite_note-:14-24\">(24)<\/a><\/sup><\/p>\n<h3><span id=\"Strengthening_Exercises\" class=\"mw-headline\">Exercices de renforcement <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Strengthening Exercises\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=19\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Strengthening Exercises\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=19\">modifier la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Selon Helene Simpson, <sup id=\"cite_ref-:13_16-2\" class=\"reference\"><a href=\"#cite_note-:13-16\">(16)<\/a><\/sup> Les exercices de renforcement des fl\u00e9chisseurs des orteils et des muscles intrins\u00e8ques du pied peuvent contribuer \u00e0 l&rsquo;activation musculaire \u00e0 la phase interm\u00e9diare du cycle de marche et emp\u00eacher les t\u00eates m\u00e9tatarsiennes de glisser vers le sol.<\/p>\n<h2><span id=\"Other_Treatment_Options\" class=\"mw-headline\">Autres options de traitement <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Other Treatment Options\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=20\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Other Treatment Options\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=20\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>La chirurgie est envisag\u00e9e lorsque le traitement conservateur \u00e9choue ou que le patient n&rsquo;est plus dispos\u00e9 \u00e0 adapter son mode de vie pour g\u00e9rer les sympt\u00f4mes du n\u00e9vrome de Morton. Les options de traitement chirurgicales et non chirurgicales suivantes sont disponibles :<\/p>\n<ul>\n<li>Excision chirurgicale des nerfs (neurectomie) <sup id=\"cite_ref-25\" class=\"reference\"><a href=\"#cite_note-25\">(25)<\/a><\/sup><\/li>\n<li>D\u00e9compression nerveuse chirurgicale <sup id=\"cite_ref-26\" class=\"reference\"><a href=\"#cite_note-26\">(26)<\/a><\/sup><\/li>\n<li>Radiofr\u00e9quence percutan\u00e9e guid\u00e9e par \u00e9chographie.<\/li>\n<li>Injection d&rsquo;alcool<\/li>\n<li>Alcoolisation avec du ph\u00e9nol guid\u00e9e par \u00e9lectrostimulation percutan\u00e9e <sup id=\"cite_ref-:0_9-8\" class=\"reference\"><a href=\"#cite_note-:0-9\">(9)<\/a><\/sup><\/li>\n<\/ul>\n<h2><span id=\"Resources\" class=\"mw-headline\">Ressources<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Resources\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=21\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Resources\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=21\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ol>\n<li><a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6375221\/pdf\/13047_2019_Article_320.pdf\" rel=\"nofollow\">The effectiveness of non-surgical interventions for common plantar digital compressive neuropathy (Morton\u2019s neuroma): a systematic review and meta-analysis<\/a><\/li>\n<li><a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7944831\/pdf\/ACTA-91-60.pdf\" rel=\"nofollow\">The effectiveness of shoe modifications and orthotics in the conservative treatment of Civinini-Morton syndrome: state of the art<\/a><\/li>\n<li><a class=\"external text\" href=\"https:\/\/www.ajronline.org\/doi\/epdf\/10.2214\/AJR.16.17276\" rel=\"nofollow\">Second and Third Metatarsophalangeal Plantar Plate Tears: Diagnostic Performance of Direct and Indirect MRI Features Using Surgical Findings as the Reference Standard<\/a><\/li>\n<\/ol>\n<h2><span id=\"References\" class=\"mw-headline\">R\u00e9f\u00e9rences<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: References\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;veaction=edit&amp;section=22\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: References\" href=\"\/index.php?title=Physiotherapy_for_Morton%27s_Neuroma&amp;action=edit&amp;section=22\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap mw-references-columns\">\n<ol class=\"references\">\n<li id=\"cite_note-1\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-1\">\u2191<\/a><\/span> <span class=\"reference-text\">Weinfeld SB, Myerson MS. Interdigital Neuritis: Diagnosis and Treatment. J Am Acad Orthop Surg. 1996 Nov;4(6):328-335.<\/span><\/li>\n<li id=\"cite_note-2\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-2\">\u2191<\/a><\/span> <span class=\"reference-text\">Riddick DA, Riddick DH, Jorge M. 7 &#8211; Footwear: foundation for lower extremity orthoses. In: Chui KK, Jorge M, Yen S-C, Lusardi MM, editors. Orthotics and prosthetics in rehabilitation (Fourth Edition). Elsevier, 2020. p164-82.<\/span><\/li>\n<li id=\"cite_note-:10-3\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:10_3-0\">3.0<\/a><\/sup> <sup><a href=\"#cite_ref-:10_3-1\">3.1<\/a><\/sup> <sup><a href=\"#cite_ref-:10_3-2\">3.2<\/a><\/sup> <sup><a href=\"#cite_ref-:10_3-3\">3.3<\/a><\/sup><\/span> <span class=\"reference-text\">Jain S, Mannan K. The diagnosis and management of Morton&rsquo;s neuroma: a literature review. Foot Ankle Spec. 2013 Aug;6(4):307-17.<\/span><\/li>\n<li id=\"cite_note-:7-4\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-:7_4-0\">\u2191<\/a><\/span> <span class=\"reference-text\">Govsa F, Bilge O, Ozer MA. Anatomical study of the communicating branches between the medial and lateral plantar nerves. Surgical and Radiologic Anatomy. 2005 Dec;27(5):377-81.<\/span><\/li>\n<li id=\"cite_note-:8-5\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:8_5-0\">5.0<\/a><\/sup> <sup><a href=\"#cite_ref-:8_5-1\">5.1<\/a><\/sup><\/span> <span class=\"reference-text\">Torres AL, Ferreira MC. <a class=\"external text\" href=\"https:\/\/www.scielo.br\/j\/aob\/a\/3PgtjmSVwWMDmCYZgbPhghq\/?format=pdf&amp;lang=en\" rel=\"nofollow\">Study of the anatomy of the tibial nerve and its branches in the distal medial leg<\/a>. Acta ortopedica brasileira. 2012;20:157-64.<\/span><\/li>\n<li id=\"cite_note-:9-6\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-:9_6-0\">\u2191<\/a><\/span> <span class=\"reference-text\">Koo GB, Lee JH, Jang JH, Song IH, Kim JY. Superficial course of the medial plantar nerve: case report. Anatomy &amp; cell biology. 2019 Mar 1;52(1):87-9.<\/span><\/li>\n<li id=\"cite_note-:5-7\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:5_7-0\">7.00<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-1\">7.01<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-2\">7.02<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-3\">7.03<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-4\">7.04<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-5\">7.05<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-6\">7.06<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-7\">7.07<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-8\">7.08<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-9\">7.09<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-10\">7.10<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-11\">7.11<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-12\">7.12<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-13\">7.13<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-14\">7.14<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-15\">7.15<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-16\">7.16<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-17\">7.17<\/a><\/sup> <sup><a href=\"#cite_ref-:5_7-18\">7.18<\/a><\/sup><\/span> <span class=\"reference-text\">Col\u00f2 G, Rava A, Samaila EM, Palazzolo A, Talesa G, Schiraldi M, Magnan B, Ferracini R, Felli L. <a class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7944831\/pdf\/ACTA-91-60.pdf\" rel=\"nofollow\">The effectiveness of shoe modifications and orthotics in the conservative treatment of Civinini-Morton syndrome: state of the art.<\/a> Acta Biomed. 2020 May 30;91(4-S):60-68.<\/span><\/li>\n<li id=\"cite_note-:6-8\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:6_8-0\">8.0<\/a><\/sup> <sup><a href=\"#cite_ref-:6_8-1\">8.1<\/a><\/sup> <sup><a href=\"#cite_ref-:6_8-2\">8.2<\/a><\/sup><\/span> <span class=\"reference-text\">Hassouna H, Singh D. Morton&rsquo;s metatarsalgia: pathogenesis, aetiology and current management. Acta Orthop Belg. 2005 Dec;71(6):646-55. <\/span><\/li>\n<li id=\"cite_note-:0-9\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:0_9-0\">9.0<\/a><\/sup> <sup><a href=\"#cite_ref-:0_9-1\">9.1<\/a><\/sup> <sup><a href=\"#cite_ref-:0_9-2\">9.2<\/a><\/sup> <sup><a href=\"#cite_ref-:0_9-3\">9.3<\/a><\/sup> <sup><a href=\"#cite_ref-:0_9-4\">9.4<\/a><\/sup> <sup><a href=\"#cite_ref-:0_9-5\">9.5<\/a><\/sup> <sup><a href=\"#cite_ref-:0_9-6\">9.6<\/a><\/sup> <sup><a href=\"#cite_ref-:0_9-7\">9.7<\/a><\/sup> <sup><a href=\"#cite_ref-:0_9-8\">9.8<\/a><\/sup><\/span> <span class=\"reference-text\">Bencardino J, Rosenberg ZS, Beltran J, Liu X, Marty-Delfaut E. <a class=\"external text\" href=\"https:\/\/www.ajronline.org\/doi\/epdf\/10.2214\/ajr.175.3.1750649\" rel=\"nofollow\">Morton&rsquo;s neuroma: is it always symptomatic?<\/a>. American journal of roentgenology. 2000 Sep;175(3):649-53.<\/span><\/li>\n<li id=\"cite_note-:1-10\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:1_10-0\">10.0<\/a><\/sup> <sup><a href=\"#cite_ref-:1_10-1\">10.1<\/a><\/sup><\/span> <span class=\"reference-text\">Mak MS, Chowdhury R, Johnson R. Morton&rsquo;s neuroma: a review of anatomy, pathomechanism, and imaging. Clinical Radiology. 2021 Mar 1;76(3):235-e15.<\/span><\/li>\n<li id=\"cite_note-:11-11\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-:11_11-0\">\u2191<\/a><\/span> <span class=\"reference-text\">Mahadevan D, Venkatesan M, Bhatt R, Bhatia M. Diagnostic Accuracy of Clinical Tests for Morton&rsquo;s Neuroma Compared With Ultrasonography. 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Available from <a class=\"external free\" href=\"https:\/\/radiopaedia.org\/articles\/mulder-sign\" rel=\"nofollow\">https:\/\/radiopaedia.org\/articles\/mulder-sign<\/a> (accessed on 14 Oct 2022) <\/span><\/li>\n<li id=\"cite_note-14\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-14\">\u2191<\/a><\/span> <span class=\"reference-text\">Cashley DG, Cochrane L. Manipulation in the Treatment of Plantar Digital Neuralgia: A Retrospective Study of 38 Cases. J Chiropr Med. 2015 Jun;14(2):90-8<\/span><\/li>\n<li id=\"cite_note-15\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-15\">\u2191<\/a><\/span> <span class=\"reference-text\">The Physio Channel. Metatarsal Squeeze Test for Mortons Neuroma and Mulders Sign. 2019. 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Foot &amp; Ankle Specialist. 2013 Aug;6(4):307-17.<\/span><\/li>\n<\/ol>\n<\/div>\n<p><!-- NewPP limit report Cached time: 20230123162610 Cache expiry: 0 Dynamic content: true Complications: () CPU time usage: 0.160 seconds Real time usage: 0.175 seconds Preprocessor visited node count: 624\/1000000 Post\u2010expand include size: 91\/2097152 bytes Template argument size: 0\/2097152 bytes Highest expansion depth: 3\/40 Expensive parser function count: 0\/100 Unstrip recursion depth: 0\/20 Unstrip post\u2010expand size: 18474\/5000000 bytes --><br \/>\n<!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 8.585 1 Special:Contributors\/Physiotherapy_for_Morton's_Neuroma 100.00% 8.585 1 -total --><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u00c9diteur original &#8211; Ewa Jaraczewska Principaux contributeurs &#8211; Ewa Jaraczewska et Jess Bell Contenu 1 Introduction 2 Anatomie cliniquement pertinente 2.1 Le n\u00e9vrome 3 \u00c9tiologie 3.1 \u00c9pid\u00e9miologie 4 M\u00e9canisme de la l\u00e9sion \/ Processus pathologique 5 Pr\u00e9sentation clinique 6 Tests diagnostiques 7 Proc\u00e9dures diagnostiques 8 Diagnostic diff\u00e9rentiel 9 Traitement \/ interventions en physioth\u00e9rapie 9.1 Les [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-4704","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4704","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/comments?post=4704"}],"version-history":[{"count":4,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4704\/revisions"}],"predecessor-version":[{"id":5664,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/4704\/revisions\/5664"}],"wp:attachment":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/media?parent=4704"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}