It is not generally appreciated that new growths of the skin on the plantar surface, especially those occurring under the heads of the metatarsals or any weight bearing area of the foot, often become a major disabling problem. A pebble or nail inside a shoe can make standing or walking next to impossible; a deep-seated callus or residual scar can do likewise, if located under a weight bearing area. The disability these growths may cause varies from a constant discomfort to complete inability to bear weight over the area. The patient often states that bearing weight on the area is like "stepping on a tack."
That some authorities have been aware of the seriousness of these problems is attested to by the drastic operations they have recommended. Dickson1 suggests excision of the entire metatarsal shaft, together with dorsal and plantar soft structures covering it, including the toe. In regard
DuVries HL. NEW APPROACH TO THE TREATMENT OF INTRACTABLE VERRUCA PLANTARIS (PLANTAR WART). JAMA. 1953;152(13):1202–1203. doi:10.1001/jama.1953.03690130018004
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