Identifier: practicalpodiatr00jose (find matches)
Title: Practical podiatry :
Year: 1918 (1910s)
Authors: Joseph, Alfred
Subjects: Podiatry Podiatry Podiatry X-rays
Publisher: New York : First Institute of Podiatry
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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teristicwhich differentiates it from the ordinary callosity. Theradix is a dark solid mass of epidermic cells which has analmost transparent ap-pearance. When cut-ting an heloma, theradix may be felt by thetension produced as theknife passes through it. H e10 m a t a durafound on the plantarsurface of the foot overthe heads of the meta-tarsal bones are notreadily distinguished,due to the fact that theyare covered by a layerof callous, which, whenremoved, exposes thenuclei to view. Prognosis. Theprognosis of helomadurum is uncertain.There are many caseson record which havedisappeared after thefirst treatment and, onthe other hand, somecases regularly recur notwithstanding many years of regu-lar attention. This is due to two conditions: first, the causeof the heloma, namely, the continued wearing of the shoe,and, second, the papillae beneath the growth remain enlargedand continue their function of excessive cell proliferation.The latter reason is more important than the first, for, even
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HELOMA DURUM ON PLANTARSURFACE 156 PODIATRY in cases where proper foot gear is provided and no frictionor pressure is permitted, the heloma may continue to grow.The only way to account for the total disappearance of somehelomata, after treatment, is, that when the growth is re-moved, the size of the papillae diminishes and normal func-tion is restored. The situation of heloma durum is veryimportant in considering the ultimate cure of the growth.Those on the outer aspect of the little toe rarely get well, dueto the prominent position of tha^K-digit, while those on theplantar surface over the heads of the metatarsals are oftencompletely cured after the proper treatment has been ap-plied. When the heads of the metatarsal bones have beenproperly adjusted, the helomata produced by their down-ward displacement gradually disappear. Treatment. The treatment of heloma durum is dividedinto three classes, viz.: preventive, palliative and opera-tive. Preventive treatment consists in securing free

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