Plantar keratoma is a painful ‘hard spot’ on the bottom of your foot that may have started out as a callus and become a painful menace. Walking on different surfaces with different types of shoes or cushioning may reduce the level of pain and/or discomfort but it never really goes away. Some have described the sensation to be like walking around with a stone in their shoe all the time.
The hard spot is the result of excessive pressure being exerted under one of the metatarsal heads which, in some cases, is the result of an excessively long third metatarsal, or even a second metatarsal which can be corrected by having an Oblique Tilt-Up Osteotomy. Intractable plantar keratoma can also be attributed to hammertoe. And, in some instances mistaken for other issues/conditions.
First-Line Medical Treatment of Intractable Plantar Keratosis
First-line medical treatment of intractable plantar keratosis (IPK) includes the following:
- Oral nonsteroidal anti-inflammatory drugs (NSAIDs)
- Anti-inflammatory injectable medications
- Orthotic devices
- Moisturizing lotions or creams
- Pumice stones and callus removers
- Foot baths
- Scrub brushes
- Paraffin baths to reduce callus buildup
- Botulinum toxin – This may be a treatment for IPK.
- Paring of callus tissue and removal of the central core
Oblique Tilt-up Osteotomy Procedure
The procedure begins with the placement of a small incision on the top of the foot. Once the area has been targeted and identified, a small wedge of bone is removed. The tip of the piece is then raised to a corrected position to alleviate the pain and successful achieve optimal results.