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Hyperkeratotic Pathology of the Plantar Foot

KERATOTIC DEFORMITIES OF THE LESSER TOES

Hard corn    Soft corn
  • considerations

Transfer of load laterally from 1st ray can occur in disorders of the 1st ray such as hallux valgus or instability of first metatarsocuneiform joint. This can cause callus formation under 2nd and 3rd metatarsal heads where the tarso metatarsal joints are quite rigid. The 4th and 5th TMT joints are quite flexible so rarely get callus formation due to transfer from the first ray

Postures of the foot that can precipitate callus formation are

  • Equinus deformity of ankle joint, causing increased forefoot loading
  • Cavus foot, generally reduced weight bearing area therefore more pressur
  • Flatfoot, if it produces a hallux valgus deformity, can cause callus over medial aspect of great toe at the IP joint
  • Varus forefoot, with lateral border more plantar flexed than medial border causes callus of lateral side of foot
  • Valgus deformity, opposite of above
  • Abnormal alignment of MTP joints, eg subluxation or dislocation, causes plantarward force on metatarsal head and callus formation

Surgical management of Discrete callus beneath tibial sesamoid

Surgical management of Diffuse intractable plantar keratoses

2. KERATOTIC DEFORMITIES OF THE LESSER TOES

Hard corn    Soft corn
  • considerations

Transfer of load laterally from 1st ray can occur in disorders of the 1st ray such as hallux valgus or instability of first metatarsocuneiform joint. This can cause callus formation under 2nd and 3rd metatarsal heads where the tarso metatarsal joints are quite rigid. The 4th and 5th TMT joints are quite flexible so rarely get callus formation due to transfer from the first ray

Postures of the foot that can precipitate callus formation are

  • Equinus deformity of ankle joint, causing increased forefoot loading
  • Cavus foot, generally reduced weight bearing area therefore more pressur
  • Flatfoot, if it produces a hallux valgus deformity, can cause callus over medial aspect of great toe at the IP joint
  • Varus forefoot, with lateral border more plantar flexed than medial border causes callus of lateral side of foot
  • Valgus deformity, opposite of above
  • Abnormal alignment of MTP joints, eg subluxation or dislocation, causes plantarward force on metatarsal head and callus formation


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