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Dorsal foot growth


The foot arch hump or dorsal foot growth is not a ganglion but osteoarthritis (wear and tear) of the joint between the inner sphenoid and the first metatarsal (TMT joint I), which results from overloading a high or low arched foot.

Marginal ridges form resulting from wear and tear and sometimes a synovial bursa on top so as to prevent the pressure of the shoe acting directly on the bone. The ridge and synovial bursa is the foot arch hump.

The foot arch hump or dorsal foot growth osteoarthritis (wear and tear) of the joint between the inner sphenoid and the first metatarsal (TMT joint I).

Treatment

Initially, treatment is conservative, using insoles and possibly shoe finishings. If complaints persist then the protruding parts of the bone and synovial bursa have to be removed surgically.

Subsequent treatment

Walking can begin the day after the operation in a special shoe. After the wounds heal and the swelling goes down customized insoles should be made to support the arch of the foot.
In case surgery has been performed on bilaterally, forearm crutches can be used for two weeks for support.

Ability to work

Despite the relatively small intervention office workers should resume work only after one to two weeks. Heavy physical activity should be resumed only after three to five weeks.

Sports activities

Sports which put pressure on the foot can only be resumed at the earliest after six to eight weeks.

Results

In over 90 percent of cases symptoms disappear completely or at least a significant improvement is achieved. If the osteoarthritis pain persists then the TMT I joint must be stiffened, though this is a rare occurrence.

Complications

Swellings sometime take 2-3 months to subside, so that only soft footwear can be worn.
Impairment of wound healing and infection can occur in about 2 percent of cases, which however has never occurred amongst our patients up until now.