• Like
Corn And Nail Presentataion To Residents
Upcoming SlideShare
Loading in...5

Thanks for flagging this SlideShare!

Oops! An error has occurred.

Corn And Nail Presentataion To Residents



Published in Health & Medicine , Technology
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads


Total Views
On SlideShare
From Embeds
Number of Embeds



Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

    No notes for slide


  • 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!