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I have a pt with painful neurovascular corns on the 1st and 5th plantar mtpj areas bilaterally.

They sit as delineated nuclei within punctate callosities. The largest is 1mm in diameter.

Debridement is weekly now and this aids dramatically in reducing discomfort.

Her RCSP is extrememly everted with marked pes planus, but this pattern typical of a supinated foot emerges on her tootsies.

recently I taped her feet with the lowdye method. This gave great comfort.

I am now considering enucleating the corns under local anasthesia with KOH crystals and a curette similar to VP method.

Any comments or ideas or other experiences? Any would be much appreciated.

 

Eh?

Which MTPJ's?

 

Mahtay.

I think it is worth a go.

When ever I have done it I have found VPs.

Why not do one first.

I do it as a 'blunt dissection' no risk of scarring.

I think some work on 'neurovascular' heloma has been done using electrosurgery but cannot give you a reference.

'Once a week', needs something more drastic, I assume you have tried all the cushioning and redirecting of pressure etc possible.

Bob