Saddle Bone Deformity – Bone on the top of Foot sticking out: Causes & Treatment

Saddle bone deformity or a metatarsal cuneiform exostosis refers to the condition in which a bone on top of the foot is sticking out or protruding. While it is asymptomatic, it may be a source of discomfort for some people, especially when one feels pain when wearing a shoe. In this article, I highlight the various causes and treatment options for this unique deformity.

What Causes Saddle Bone Deformity?

What are the main causes of the bone on the top of the foot sticking out? Well, metatarsal cuneiform exostosis occurs as a consequence of hypermobility of the First metatarsal cuneiform joint.

It should be noted that the Hypermobility of a given joint can bring about the damage of the joint after a while. So as to protect against this destruction, spurring takes place at the periphery regions of this joint.

Why spurring? Well, spurring is usually an attempt by the joint to restrict hypermobility. In the event of a metatarsal cuneiform exostosis, the spurring is usually best shown around the top (aka the dorsal) part of the arch.

You should, however, note that in sophisticated instances, the spurring might become noticeable around the medial as well as plantar areas of the metatarsal cuneiform joint.

Some of the factors that contribute towards the development of the saddle bone tissue consist of generalized hypermobility.

Secondly, the contributing factors that induce the pain observed along with these bones may consist of wearing tight-fitting boots or shoes, especially those with laces that run over the saddle bone.

What these shoelaces do is to compress the deep peroneal nerve thus resulting in the development of a protruding lump on the arch.

Symptoms of Saddle Bone Deformity

It is somehow hard to list several symptoms of this deformity because they tend to be manifestly clear. However, that notwithstanding, metatarsal cuneiform exostosis can be diagnosed with:

  1. Discomfort together with direct pressure coming from boots or shoes, especially if shoelaces run across the saddle bone
  2. Asymptomatic without any direct pressure coming from the shoes
  3. Presence of pain and discomfort that can be identified as a dull ache which extends towards the first and/or the second foot toe
  4. The existence of focal lump/bumps of the saddle bone (exostosis) over the dorsal arch

Similar Diseases – Differential Diagnosis

What most people do not know is that there are other diseases/conditions with symptoms that may imitate those of the deformity in the saddle bone. Some of the common similar health issues are:

  1. Deep peroneal nerve entrapment
  2. Ganglionic cyst
  3. Arthritis

Saddle Bone Deformity Images

Images or pictures of the saddle bone deformity clearly indicate the bump on the saddle. This may as well appear as a swelling or a hard lump on top of a foot under the skin. See the images below just in case you are not sure how it looks like.

how a saddle bone deformity looks like
saddle bone deformity

 

image showing bone arrangement in saddle bone deformity
Bones in Saddle Bone Deformity

Treatment of Bone on Top of Foot Protruding

Can saddle bone deformity be treated? Yes, this complication can be treated through several approaches.

  1. Lessen the stress over the foot by putting on much deeper shoes. There are many brands of footwear which are much deeper as compared to average, but they’re nevertheless attractive to most wearers.
  2. Use Contact orthotics: You may embrace foot orthotics to prevent the jamming together of the 2 bones. It should be noted that a good arch support besides stopping the collapsing of the foot, reduces the discomfort. In addition, it aids in preventing the bump from increasing in size. One of the best ways to achieve this is by using total contact orthotics – which is a special custom orthotics. For people with small bumps, consideration may be made for some arch supports, which can be purchased over the counter.
  3. Steroid injection: In some cases, there exists an inflamed bursa on the bone deformity, which may be cured with the injection of a steroid such as cortisone. In the event the lump is just as a result of bone tissue, then injections will likely not help out.
  4. Shoe Stretching: In order to heal the protruding bone on top of the foot, you can have your shoes or boots stretched over the bump.
  5. Saddle pads: You can also make use of pads to minimize pressure over the bump. It is recommended to work with a long-lasting gel pad that is U-shaped to take pressure away from the lump.
  6. Check shoelaces: You may need to change the shoe-lacing method so that your laces bypass the region with the lump. Also, you can make use of shoelaces with elastic properties so that the shoe gives a little bit on the bump.
  7. Surgery: In the event that all other conservative treatments fall short. A surgical procedure is an alternative worth considering. This can help in removing the bone deformity. This particular surgery is generally successful. However, in virtually all instances this problem can be treated without having to do surgery on the patient.

Metatarsal Cuneiform Exostosis Surgery

As stated earlier, saddle bone deformity can be addressed by performing surgery on the patient. A surgical procedure can get rid of the bone build-up – also known as exostosis. It is usually carried out within an hour by a skilled orthopedic surgeon.

A podiatric physician may also perform it. After the surgery, most patients are reportedly are capable of stand on the foot immediately. The complete functioning of the feet can be accomplished after a couple of weeks.

Some medical practitioners may recommend making use of open-toe shoes in the few weeks prior to the surgery to protect you from just about any unneeded stress over the deformity.

Saddle bone deformity surgery cost

The cost of performing this surgery varies from one surgeon to another. For example, In most US Hospitals, the cost for non-insured patients ranges between $6000 to $11000

Saddle bone deformity pads

In some patients who insist wearing shoes despite the saddle deformity condition, use of saddle pads is usually recommended. These pads ensure that there is less pressure applied to the bump by the shoe. Saddle pads come in many shapes, but it is recommended to use the u-shaped ones.

Saddle bone deformity running

Some of the patients visit healthcare facilities with metatarsal cuneiform exostosis due to running. The care of such a deformity is as discussed here above. So next time you realized the top of the foot is sticking out after running, just know that is a saddle bone deformity.

READ MORE: Dead Skin in Between Toes Peeling off

References on Saddle Bone Deformity

  1. FOOT & ANKLE: What causes bumps on top of the foot?
  2. FOOT SHOP: Deformity Causes & Treatment
  3. COSTHELPER: Bone Spur Treatment Cost

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