Barry Katzman

5th Toe Corns

The 5th toe corn is one of the most common problems seen by a Podiatrist. In all shoes the first toe and half the second toe occupy fifty percent of the front of the shoe. This presses the other three and a half toes into the remaining half of the shoe. Shoe pressure is also greatest upon the fifth toe. The fifth toe generally moves downward and rotates inward as we mature due to inherent weakness. As a result, the toenail faces the side of the shoe. This is known as varus rotation.

The 5th toe has 3 bones forming 2 joints. Each of these bones is wide at the end and narrow in the middle. Just press your toes to feel the natural bumps in these bones. Your shoes put constant pressure on them. This irritation signals the toe to form a protective hard layer of skin. This hard skin eventually becomes a further source of irritation to the toe and eventually a painful spot develops in it center. We now have a corn. Removal of the corn by “shaving” with a scalpel blade or knife will provide temporary relief, as will corn pads or chemicals which could lead to dangerous complications. Since the shoe pressure continues to press against the bone(s), the corn and its intense pain will probably recur. This temporary treatment , known as palliation, is usually repeated every few months. For those chronically painful corns in patients whose medical condition does not exclude them, surgical correction is often available. Generally, treatment for this type of problem usually begins with x-rays. Examination will reveal the bony prominence(s) that is at the root of the problem. After the bony prominences are surgically removed, usually under local anesthesia, a special open toe shoe will be worn for 2-3 weeks after surgery.

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