I recently gave a Webinar on the topic of medial pinch callus. In this Webinar, we went into considerable detail on the best orthotic prescription to treat and prevent hallux pinch callus. One of the questions that we received after the Webinar was a request to review the most important orthotic additions for treatment of hallux pinch callus. In my opinion, those are the reverse Morton’s extension and the application of a PTFE patch.
The reverse Morton’s extension acts to allow plantarflexion of the first ray during toe-off. Along with an orthotic device that is pathology specific for hallux limitus it will enhance first MPJ motion allowing the patient to propel forward with limited abduction of the foot. This prevents the patient from rolling over the side of the hallux, which is the underlying cause of the hallux pinch callus.
The second important modification is a PTFE patch. The PTFE patch is an extremely low coefficient of friction material that is applied to the top cover of the orthotic directly under the location of the callus. Since friction plays a large role in formation of the callus, the use of the PTFE patch to decrease friction should decrease callus formation. The PTFE patch is a critical component of any orthosis designed to treat or prevent the medial hallux pinch callus.