Abstract
Soft corns between the fourth and fifth toes can be disabling and are sometimes challenging to treat. Aside from shaving of corns by patients themselves, treatment modalities include corn excision with or without flaps, condylectomy, and excision of the base of proximal phalanx of the fourth toe with or without syndactalising the fourth and fifth web space.
Between July 1997 and March 2002, we treated 50 consecutive patients (70 toes) with soft corns. Over 80% of patients had associated hard corns and the rest had hard corns, soft corns and hallux valgus. We performed hemicondylectomy of the proximal phalanx and base excision of the middle phalanx of the fifth toe. Congruency of the proximal interphalangeal joint of the fifth toe was achieved.
The soft and hard corns were not excised and healed within eight weeks. Patients experienced immediate pain relief. One patient developed a painful neuroma and two needed subsequent surgery to the fourth toe. No soft corns recurred.
Proximal phalangeal hemicondylectomy with concomitant excision of the middle phalanx base of the fifth toe is a simple procedure offering immediate and lasting pain relief.
The abstracts were edited by Prof. M.B.E. Sweet. Correspondence should be addressed to him at the Department of Orthopaedic Surgery, Medical School, University of the Witwatersrand, 7 York Road, Parktown, 2193 South Africa
