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Corns, Callouses and Bunions

The following appeared recently in Timesonline http://www.timesonline.co.uk/tol/life_and_style/health/article5675591.ece
“Corns and calluses are usually the result of a bone prominence rubbing against another bone, causing hard skin. You can get that corrected surgically, so the corn doesn’t come back. It is an easy condition to treat and you won’t have to spend the rest of your life visiting the chiropodist.
People are often badly advised on bunions – prominent and painful lumps caused by an outcrop of bone near the big toe joint. If you don’t get them treated surgically, there is a risk that your big toe will become less functional and your second toe overloaded. This can lead to hammer toes, a condition that makes wearing any footwear, not just fashion shoes, difficult.
Mark Davies is a foot surgeon and founder of the London Foot and Ankle Centre http://www.bofas.org.uk”

I can find little to agree with Mark Davies. Neither corns nor callouses are “the result of a bone prominence rubbing against another bone”. Corns are a response of the skin to abrasion against footwear and calluses are a complex (but easily corrected) foot-floor interface problem. A “soft corn” is unusual, but does result from follow pressure between the toes, almost always when there is an “osteophyte” (a small arthritic prominence from the joint) present.
“Bunions” are not caused by “an outcrop of bone”, and I invite anyone to demonstrate such an outcrop to me. “Bunions” are a prominence of an entirely normal metatarsal bone pushed into an abnormal position . Cutting a “bunion” away damages a normal bone and its benefit is short-term and mostly cosmetic. This destructive surgery usually causes long term problems in the great toe joint. The very structures which prevent the great toe from “veering” are destroyed by this procedure: shoul anyone therfore be surprised that cutting away “bunions” causes the great toe to veer even more?
Veering of the great toe is totally unrelated to “hammering” of the lesser toes, and therefore advising correction of a big toe on the basis that it will benefit the lesser toes is entirely incorrect. The abnormalities of the lesser toes are entirely independent of abnormalities in the great toe.  Lesser toe abnormalities will continue to progress regardless of what surgery is performed on the great toe.

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