Saddle bone deformity is a enlargement of bone on the top of the foot just in front of the ankle. That is the part of the foot that often gets referred to as the saddle. The technical name for this is a dorsal metatarsal cuneiform exostosis. Dorsal means top. The base of the first metatarsal and the medial cuneiform are the bones that are involved. Exostosis means enlargement of the bone, hence the name. There are a number of different causes for this, most of them biomechanical. The biggest problem with the saddle bone deformity is pressure on the enlarged bone from the shoe. This may cause a bursitis or may caused shooting pains from a pinched nerve or just be painful from the pressure. The best way to treat a saddle bone deformity is to remove the pressure causing the symptoms. Conservatively this can be with better fitting shoes and or pads shaped like a doughnut to get pressure off the enlarged bone. Surgically, the management is a removal of the enlarged bone.
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