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lump on sole of foot

My six year old daughter had a wooden splinter in the sole of her foot. We thought we has removed it all but a hard lump has grown over the site of the wound. what is this and what can we do to help her as she deos not do to well at the Doctors.


RESPONSE
Hi,
Many children do not do well at the doctors but that is not a reason to avoid dealing with this problem.
If the original wound has closed up, it sounds like she is developing a granuloma. More than likely there is still some wood in the foot. What the body does is forma "wall" around the wound (granuloma) in an effort to separate the foreign body from normal surrounding tissue.
Because you describe it as hard it sounds like a granuloma as opposed to an abscess that may form is an area is infected, but for whatever reason the "opening" to the wound closes. Usually abscesses will be softer when pressing them and there will be more cellulitis, the spreading of redness around the wound.
In any event your daughter should be seen by a podiatrist in your area. They tend to be much better (and gentler) at dealing with these types of situations. It is rare that I ever have to use local anesthesia to alleviate the problem.
Prior to doing anything you might want to consider having an ultrasound to see if there is any wood still in the wound. By doing this first it will eliminate the need for the doctor to have to "search" around for wood; its either there or it is not and knowing the answer to this before hand makes it easier on everyone concerned.
I obviously do not know your daughter but if she is terrified of this whole prospect it would certainly be possible to take her to a surgery center or to the hospital and have this done under sedation to reduce her apprehension.
It would be a very short case and could be done under intravenous sedation, meaning she would not have to have any general anesthesia.
This is something that needs to be taken care of for two reasons. One the chance of infection and two the fact that I assume it hurts to walk on since it is on the bottom of her foot.

Marc Mitnick DPM
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