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Posts for tag: hammertoe chattanooga

March 22, 2015
Category: Surgery

    It amazes me when I hear a marketing guru (who has little knowledge of podiatry) tell his "herd" (all of those who follow him) that one of THE most successful ad campaigns has been run in the National Enquirer for years - and is worded something like this : "CORNS GONE IN FIVE DAYS OR MONEY BACK!"  No - he isn't lying - and I have a great deal of respect and admiration for the man who took note of this fact, and I am sure he is right.  It IS a great headline to SELL something!   What the company is or was selling (I don't subscribe to the National Enquirer, so I don't know if the ad is still being run) is a product containing SALICYLIC ACID.  While this topical acid preparation is an appropriate treatment for WARTS, which are only skin deep, and due to a virus, this is the WRONG treatment for a corn.  Not only will Saliylic acid NOT "get rid of corns", in many people it causes very undesirable side effects:  INFECTION, ULCERATION, and in those with circulatory problems and diabetes maybe even AMPUTATION!   Of course, there are always disclaimers, in very fine print, that tell those with diabetes and/or vascular disease NOT to use the product.  By this time, the product has probably already been bought and paid for.  In addition, many of those with diabetes have problems seeing the fine print, but the company selling such products made sure they could read the CORNS GONE OR MANY BACK headline.  It is true that these acid preparations will cause the corn (dead skin) to "peel off", but  this is a temporary fix and is due to the "medication" or pad containing the acid to BURN the skin!   Buyer beware!

   Corns are a buildup of thick skin, almost always forming over a bony prominence.  The are most common on the top of a hammertoe (a toe which is contracted or "bent" such that the tip of the toe now touches the ground and the top of the toe "sticks up" rubbing the shoe), on the tip of a toe (from pressure being displaced and now the tip of the toe has weight on it rather than the bottom of the toe), OR between two toes (often called soft corns) such as when two toes are too close together and rubbing, causing the pressure to occur over a bony "spur".  There are basically only three ways to safely treat corns.  One is to trim them, or have them trimmed.  Podiatrists do this all the time.  It is not surgery and is often called routine foot care, similar to a dentist doing cleaning of the teeth or other hygienic measures to prevent further problems.  It is not glamorous, or difficult, but a patient should not be using a blade or a scissors to trim a corn or callous.  The second is to relieve pressure on the outside of the toe.  This can include padding, lamb's wool, silicone sleeves or toe crests to either keep the toes aprart, or relieve pressure from the top or sides of the toe.  Neither the first nor second option will "get rid of the corn."  In some cases, however, this may be the best option.  If the individual is not in good health, has peripheral vascular disease, or just isn't ready for surgery, these first two options will reduce discomfort, make it easier to walk, and at least give relief for some time.

   Surgery for a corn does not mean "cutting the corn out as deeply as possible."   It typically means correcting the underling bony deformity.  If the toe is crooked, straighten it.  If there is a "spur" on the side or end of the toe, remove it.  Sometimes a combination of the two are done to relieve pressure by repositioning the toe(s) or even shortening them slightly to redistribute weight on them.  This can always be done under a local anesthetic agent, and in an office setting as long as the physician has a sterile set up and the appropriate instruments.  In many cases, the procedures may take only 30 minutes or less.  In the vast majority of cases, the patient can walk right away, albeit it in a surgical shoe or boot, and with limited time spent on the feet.  Of course, as with any surgery, there are always possible risks, such as slow healing, infection, prolonged swelling, etc.  The incidence of severe complications, however, is very low.  Sometimes the risk of NOT doing surgery outweighs the risks of the surgery.  If a diabetic patient has a corn which becomes ulcerated, and the ulcer cannot be closed with conservative treatments, surgery may be indicated.  As long as the circulation is adequate, and the blood sugar is under control, there may be a higher risk of amputation if the underlying toe deformity is ignored.  That could lead to bone infection (osteomyelitis), spread of the infection, loss of limb, and even loss of life.

   No matter which option is chosen for treatment of a painful corn and/or underlying toe deformity, anyone or any company which promises "CORMS GONE IN FIVE DAYS OR MONEY BACK!" is not to be trusted.

   Richard S. Eby, DPM

   3603-E Ringgold Road

   Chattanooga, TN>  37412

(423) 622-2663