Foot ran over by car 2 years ago

2 years ago my right foot was run over by an suv. I went to the ER, had xrays and was told there was no visible injury and it would get better. It seemed to be mending rather slowly. A year after the accident I was still having pain when walking or touching the top of the foot. I went to a sports med podiatrist and after examination and more Xrays was told that "it was a crush injury and would heal in time." It has now been two years since the accident and the pain has been getting worse. There is a constant pain on the under side of the little toes, tenderness on top of the foot and pain when sitting cross legged and the pressure is on the side. When standing after not having pressure on my foot for an extended period of time, I have a slight limp as my foot does not feel normal when pressure is on it.

RESPONSE

Hi,

I think a little commonsense on the part of the Emergency Room and the subsequent podiatrist (btw, what does sports medicine have to do with a SUV running over your foot?) would be in order.

If the average SUV weighs approximately 3500 pounds and the weight is distributed fairly evenly then approximately 875 pounds ran over your foot. I understand the notion of taking x-rays as certainly there was a chance of fracture or damage to one of the joints in your foot. Did it not dawn on either of these two doctors to suspect that there could have been damage to the soft tissues of the foot; soft tissue being everything but bone?

The Emergency Room should have put you non-weightbearing on crutches, possibly a cast for no other reason to not allow any further damage to your foot. Along those lines, I would have told you after two weeks or so if there was no improvement then further medical attention would be required.

I think the advice from the podiatrist was even more ridiculous. Here you are one year post trauma and I am going to assume you still have significant pain, otherwise you would not have sought additional medical attention. He tells you it is a crush injury (gee, how observant!) and then tells you it will get better in time. What is his time frame? 30 years?

Most significant injuries if not treated in a timely manner reach a point of diminishing returns, meaning after a period of time, they become less resistant to treatment. In the foot this is particularly more distressing because as you keep walking, just every day walking on the injured foot, you are constantly doing more damage.

I will not pretend to know what is actually wrong with your foot but you need to see some doctor who will not only check the tendons and ligaments that control your foot, but you also have to have the blood vessels and nerves that run into the foot examined as well.

An MRI would be a good place to start. It will show soft tissue damage and may also show some bone damage that may have not been visible on x-ray. If there is nerve damage or possibly damage to some of your blood vessels further examination will be required.

The question then becomes what can be done two years after the trauma? As I said earlier, physical therapy would have been more effective than at this point in time, but it still may be beneficial. If there is nerve damage, nerve therapy or medication may be necessary.

You do not mention any swelling or discoloration in the foot,so there may not be a vascular component to your pain, but again, I am just guessing.

I would think a physiatrist might be the type of medical specialist to start with. Visits to a neurologist, orthopedist and podiatrist may also be necessary.

Marc Mitnick DPM
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