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The response to the question below was authored by Marc Mitnick DPM
injury to bottom of foot
by angela
(morganton, nc.)
Hi.....I have a very big problem and im looking for help. About 5 years ago, I stepped into my closet looking for for something. Im not really sure what it was doing there but I stepped barefooted onto a compound bow. The area affected was from my little toe going towarded center of my foot direction. I went to the hospital, the blade was clean and shots were up to date. They decided to glue the cut shut instead of stitches because of scars that could complicate padding of my foot.it formed a knot about the size of a dime. It feels like a bundle of nerves severely painful. It affects my walking and actually causes my little toe to pull away from my foot due to the knot. I have to remove the dead skin constantly. Its almost like a hardened cone shape piece of dead skin with a core keeps forming. The round scar is now seeming to grow long that extends down the bone in the middle of my foot. I understand that I have to deal with the scar and dead tissue but is there anything they may have to do to it??? I cant deal with the pain and it causes alot of walking problems.
RESPONSE
Hi Angela,
Without actually examining your foot, I cannot tell exactly what is going on but based on your history and your narrative, you have either a granuloma in your foot or excessive scarring of the wound.
A granuloma would be a growth formed under the skin as a result of the cut. Typically, a granuloma is made up of inflammatory tissue. A typical example would be if the wound was not completely clean at the time of the incident and by glueing the wound shut,
The other possibility from where I am sitting on the other side of the internet would be scar tissue from the wound itself.
It sounds like they were right when they said that you have to be aware of scars on the bottom of the foot, but I do not think glue is the answer.
The reason we worry about scars on the bottom of the foot is because the skin on the bottom is under a lot of tension, meaning when you walk, you excessively stretch the skin. Thus a wound on the bottom of the foot would be prone to opening and thus scarring due to this pressure if precautions are not taken.
Typically, wound such as these are sewn with retention sutures which help reduce the tension across the wound as well as making the patient walk non-weightbearing on the affected foot for a couple of weeks.
Hopefully, in addition to glueing the wound shut, they also put you on crutches. If not, my guess is your problem is excessive scarring.
All is not lost. I would recommend an MRI to get a better picture of what is causing the problem.
In general, both problems I have described can be repaired with further surgery and proper non-weightbearing care after the surgery.
I would suggest you see a good foot specialist in your area.
Marc Mitnick DPM
DISCLAIMER
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ADDITIONAL REFERENCES
University of Rochester Medical Center
American Academy of Pediatrics
Columbia University Department of Rehabilitation
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