Excessive HK build up & HD formation

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Hi All,
I am new to this and studying 3rd year Podiatry at the moment. I am just curious as to find out what exactly causes excessive hyperkeratosis build up and a heloma dura formation sub 3rd MTPJ. I know HK is formed by plantar pressures etc, but if there is excessive HK sub 3rd MTPJ would that be linked to slight supination of the foot? what other pathological gait patterns could cause HK under this area as well?
This might sound petty, but it's always good to clarify things when it's puzzling you, right?

Thanks
Alice

 

Hi Alice,

You might consider weak or incompetent medial or lateral columns and the increased frontal plane motion that then occurs across the middle met heads. Toe-walkers also load the forefoot excessively. Supination and pronation states present the foot to the floor not as intended, and so do misplacement of the acetabulae, femoral anteversion, tibial torsion and tibial varus conditions. It is sometimes necessary to look outside the foot to understand problems of the foot.