Saddle bone deformities become painful when trying to fit into enclosed shoes.  Also, saddle bone deformities tend to develop immediately beneath the deep peroneal nerve.  Painful nerve compression of the deep peroneal nerve can result when pressure is applied to the nerve and underlying saddle bone deformity.

Treatment of Saddle Bone Deformities

Conservative treatment of a saddle bone deformity includes avoidance of direct pressure to the bump (exostosis).  Open shoes, such as flip-flops or low cut dress shoes can help to limit direct pressure to the saddle bone deformity.  Padding can be used to protect the saddle bone from compression by the shoe.  The images at left show how to use a tongue pad to create a small pocket on the underside (tongue) of the shoe.  This pocket places pressure to the medial and lateral sides of the saddle bone.

Surgical correction of a saddle bone deformity requires resection of the dorsal exostosis.  By removing the exostosis, compression of the deep peroneal nerve is relieved and patients can return to enclosed shoes.  Resection of a saddle bone is a procedure that takes approximately an hour to complete.  This procedure can be performed in a hospital or surgery center using general anesthetic or local anesthesia and sedation.  Patients are able to bear weight on the foot immediately following surgery.  Return to normal activities take approximately 4-6 weeks.