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lump on top of foot 5 weeks after dropping an object on it

my daughter is a majorette and 5 weeks ago she dropped her mace tip end onto the top of her foot. it bruised and swelled at the time but we assumed that it was just badly bruised at the time as she could walk ok on it. however 5 weeks down the line and her foot is still slightly swollen and a hard lump has formed where the mace landed. could she have broken it without us realising?


RESPONSE

Hi,

I would think that simple trauma to the top of the foot in a young person would have healed five weeks down the road. The only thing that I can think of that would have delayed the healing process would be damage to the extensor tendons on top of the foot. These are the tendons that bring the toes upwards.
I would assume your daughter does a lot of walking and other activity and that is the case then it would not surprise me if the tendons continued to ache.
The reason for this is because the simple act of walking causes the tendons to "work" and therefore they never really have a chance to rest. So as she keeps walking and doing every thing else that she does (marching), then the tendons will stay inflamed and continue to hurt.
I am assuming the tip of the baton that hit her foot is rubber tipped and damage to the tendons would be the most likely scenario.
Having said that there is always the chance that she actually chipped a small piece of bone. This will happen in many instances where there appears to have only been minor trauma.
The fact that the area feels "hard" may be an indication that there is a broken bone. I say that because as the broken bone begins to heal the immediate surrounding area forms a lattice network for new bone to come in and heal. While this new bone formation is going on the area will feel hard and larger than the original area after it was traumatized.
The hard area however, does not only have to be a result of a fracture.
Since there are many superficial veins right under the skin, she may have broken one of those blood vessels. The area would have become swollen and redish purple in color. At five weeks post trauma, the dry blood could account for the hard lump on top of her foot.
As you can see I am only giving you a lot of conjecture.
Since it is five weeks since the trauma, why not take her to see a foot specialist in your area and let a doctor x-ray and examine the foot to find the true cause of the hard swelling?

Marc Mitnick DPM
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