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When seeing patients with IKM - Intractable Plantar Keratosis and with a single site lesion what are the best conservative treatments when the site is less than 1 cm in diameter. Which pads are best to start using to relieve pressure at the site. This is a single site lesion in the second - third toe region on the metatrasal pad. What are some of the better recommendations for the conservative treatment approach. Also what tests are the most appropriate.

 

Hey Timbo.

It rather depends on the nature of the keratosis.

A keratosis tells us only that there is a growth of the skin. Could be callus, H durum, Hmille, V pedis, fiberous HD or "other". The best treatment will depend on which it is. 2-3rd suggests its not on the met head and if its a single lesion it raises questions about what it is.

A photograph would be most useful.

depends on the exact location of the lesion and the nature of the foot.

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Depends on the nature of the lesion.

We need more information to help you.

 

Age? Abnormal Biomechanics, or structural deformity? Available ROMs etc? Gait findings? Type of pad will also depend on whether your goal is to improve function or simply provide palliative deflection.