Corn And Nail Presentataion To Residents
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Corn And Nail Presentataion To Residents

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Corn And Nail Presentataion To Residents Presentation Transcript

  • 1. Nails, Corns and Stuff* *(or how I spent an afternoon listening to the most boring lecture topic on the planet)
  • 2. The Common Corn • Also known as an heloma dura lesion on the toe or a tyloma on the bottom of the foot • Commonly have bursa underneath with nerve entrapment
  • 3. The Common Corn How do you cut these things (and what’s the big deal)? When do you stop? [blood is a good guide that you’re done, bone is a definite] What if they’re too painful to cut? [possible use of local block before and cortisone in the bursa after] What makes these things occur [bone spur and contractures with poor shoes] How can I keep them from coming back? [Δ in shoe gear and padding if minor, surgical resection of spur if chronic and debilitating]
  • 4. The Common Corn • What if it walks like a corn and quacks like a corn, but isn’t a corn? [hammer toe without heloma dura lesion formation] • How do you treat stuff like this? [padding, shoes, emollients] • Can you keep it from coming back? [pressure causes the problems, relieving pressure will ameliorate it if not alleviate it]
  • 5. The Uncommon Corn • This is Charcot neurotrophic osteoarthropathy with sub-navicular prominence and callus from weight- bearing.
  • 6. The Uncommon Callus • The IPK (intractable plantar keratosis) • Deep core • Associated with plantarflexed metatarsal head and contractures
  • 7. Callused skin • Xerotic skin • Can be associated with genokeratosis disease states such as Diabetes Mellitus, Unna-Thost and variants, certain heavy metal poisoning • Do you debride this?
  • 8. Nail Problems • Thick, nasty, brittle and hard • Often seen in Diabetes Mellitus patients • Pressure upon nail bed can lead to ulceration • Either thin the nail or surgically remove
  • 9. Nail Problems • Fungus allows lysis from the underlying nail bed • Definite hazard to catching on sock and traumatically avulsing
  • 10. Nail Problems • Ingrown nails can cause a more involved infection • Long-term relief involves surgical resection and cautery of the matrix • Procedure is painless if the initial block is good
  • 11. Nail Problems • After care includes Epsom salt soaks and light dressing with antibiotic. • If adequate matrixectomy was done, the nail shouldn’t regrow
  • 12. Thank you!