Where fibrofatty padding is absent or greatly diminished, a cushioned insole, or felt padding can reduce plantar pressures. Patches of silicone gel can be applied over the metatarsal heads. If FFPD is associated with raised arch and clawed toes, a cradled insole in a bespoke shoe will be needed.

Hallux rigidus/limitus

A rocker sole can be applied to the sole of the shoe by an orthotist to reduce pressure at the end of the walking cycle when the toe leaves the ground. This condition may require surgical correction. Callus should be regularly debrided.

Hallux valgus

Extra-width stock shoes or bespoke shoes will be needed. Foot drop

Foot drop can be accommodated by an ankle-foot orthosis (AFO) which can be of the traditional metal and leather calliper type or the more recent thermoplastic type. Sprung joints to assist dorsiflexion may also be added but will make the AFO heavier.

Management of corns, callus and fissures


Corns should be removed by sharp debridement with a scalpel. Interdigital corns may be moist and grasping them with a forceps helps maintain tissue tension. Felt padding may be used to deflect pressure but needs to be checked regularly.

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