Soft Corns

[sinustarsi]

---

Members don't see this ad.

I just saw a pt with soft corns Interspace 4th. They are usually painful for most patients. Is there something quick that can be done in the clinic for these pt or they had to taken to the OR which requires more time. I think debridment of callus does not give them 100% relief. The reason I am asking is that this kind of reminds of a toothache. Dentist will have this addressed in their clinic and you walk out pain free. Are most pods taking these in the OR to shave the offending border even thought it's a 5 min procedure? Thanks.

 

[347932]

I just saw a pt with soft corns Interspace 4th. They are usually painful for most patients. Is there something quick that can be done in the clinic for these pt or they had to taken to the OR which requires more time. I think debridment of callus does not give them 100% relief. The reason I am asking is that this kind of reminds of a toothache. Dentist will have this addressed in their clinic and you walk out pain free. Are most pods taking these in the OR to shave the offending border even thought it's a 5 min procedure? Thanks.

Debride tyloma and silicone interdigital pad. If that doesn't work, on their f/u visit get some radiographs and discuss surgical exostectomy or hammertoe repair.

In my experience, most of these end up in the OR at some point or another.

 

[NatCh]

I just saw a pt with soft corns Interspace 4th. They are usually painful for most patients. Is there something quick that can be done in the clinic for these pt or they had to taken to the OR which requires more time. I think debridment of callus does not give them 100% relief. The reason I am asking is that this kind of reminds of a toothache. Dentist will have this addressed in their clinic and you walk out pain free. Are most pods taking these in the OR to shave the offending border even thought it's a 5 min procedure? Thanks.

My approach is similar to that of Kidsfeet. I will sharply debride the hyperkeratosis and dispense a Silipos toe sleeve, plus recommend a shoe with a wide toe box. If the condition returns (which they often do) I will discuss either exostectomy, hammertoe repair, derotational arthroplasty/Shaw Rod or if the heloma molle is deep within the interspace I will perform a partial syndactilization, all dependent upon what ever is indicated.

Edit: if I take the patient to the operating room, it will be for more than simply shaving the corn. If your patient is having too much pain in the examination room when you try to shave the corn, consider an injection of local anesthetic (digital block) if not contraindicated prior to debridement.

 

[Feli]

Debride tyloma and silicone interdigital pad. If that doesn't work, on their f/u visit get some radiographs and discuss surgical exostectomy or hammertoe repair.

In my experience, most of these end up in the OR at some point or another.

Yep.^^

Usually a 5th digit PIPJ arthroplasty with excision of head of prox phalanx + any other indicated procedures (usually derotational skin plasty of 5th and maybe other stuff depending on foot). Some attendings will also do exostectomy of medial flare of 4th prox phalanx base as well as 5th plasty for the 4/5 webspace corns, but I don't think that's needed in most cases.

 

[NatCh]

........

 

[347932]

Yep.^^

Usually a 5th digit PIPJ arthroplasty with excision of head of prox phalanx + any other indicated procedures (usually derotational skin plasty of 5th and maybe other stuff depending on foot). Some attendings will also do exostectomy of medial flare of 4th prox phalanx base as well as 5th plasty for the 4/5 webspace corns, but I don't think that's needed in most cases.

Errrr huh?

4th interspace is lateral 4th toe and medial 5th toe. So 5th PIPJ arthroplasty with derotational skin plasty and exostectomy of the LATERAL aspect of the either the head of the Prox Phalanx of the 4th toe or exostectomy of the LATERAL aspect of the base the prox phalanx of the 4th toe depending on where the painful tyloma lies. I hope my coffee has kicked in and that is right.