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The response to the question below was authored by Marc Mitnick DPM

Ball of foot pain.

I jumped onto a glass bottle,and cut my foot as it smashed. There was alot of blood but the cut was tiny. The next day i could hardly weight bear and alot of my foot was bruised, I couldn't go to a & e as I had to go to work. 3 days on my little toe started to look bruised and the pain in the ball of my foot was still there. I suspected glass was still in my foot so I soaked in epsom salts and i found tiny fragments of glass coming out. I have left it to heal for 5 weeks but still have alot of pain in the ball of my foot, I can't bend my 4th little toe as easy as my others the same toe that was bruised. I have been to the doctors today and she sent me for an x-ray. The x-ray showed that I have no glass left in the foot but bone growth where the impact happened? They said it usually takes months for this to develop and there is nothing they can do but send the report off to my doctor. Is this normal?

RESPONSE

Hi,

No, this is not normal. If you had a simple cut and all the glass was gone, then five weeks down the road I would assume your foot would be healed and it is not.
There are a couple of issues here. First of all, an x-ray will not always show glass fragments particularly if the glass does not have any lead in it. What you really need is an ultrasound which is far better as picking up glass fragments.
The thing that really bothers me about your narrative is your statement that you have bone growth where the accident occurred. What that means to me is the possibility that you have a bone infection also known as osteomyelitis. I do not know what other kind of "bone growth" you could possibly have as a result of stepping on glass.
I would suggest you see a foot specialist or any doctor who is familiar with foot trauma as five weeks is too long for this to still be going on and based on your story it actually sounds like it is getting worse.

Marc Mitnick DPM
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Aug 26, 2014
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Thank you Dr. Marc
by: Anonymous

Your reply is very helpful. I've been searching for info on a similar incident. Maybe you can help guide me. I'm currently looking for another foot doctor after two visits to one who didn't seem to be very good.

Last year my son cut his foot while at the beach. He doesn't remember if it was glass or rock that he stepped on. It wasn't a huge cut, maybe 1/4 inch in length, right in the center of the ball of his foot (below and in line with his middle toe).

He picked something out of it and cleaned it out with peroxide when he got home. The cut healed. About 5 or 6 months later, he developed pain in the same place that the cut was in and a "growth" in the same spot as well. It looks similar to a callous but the pain is "inside" he says. It hurts to walk on it.

His knee doc took an xray for us which showed no foreign body. Thanks to you I now know that ultrasound is more reliable for that.

I took him to a foot doctor and that doc looked at it and in a split second said it was a wart. I asked about the internal pain and the location being exactly where the cut had been. He said it was a wart. He hit it with a laser and told my son he was good to go. After two weeks, no change. My son went back for his follow up and the doc hit it again with the laser (this time I was furious because he didn't even use a topical agent before shoving the needle into my son's foot).

Here we are two weeks later, after 2 laser treatments, and there's been no change in my son's foot. I am however, changing doctors.

Any additional insight from you would be great!

RESPONSE

It may very well be a wart as they have a tendency to develop in "breaks" in the skin such as stepping on glass or other items.

The problem here is that there may also be some foreign body (glass, sand, wood) underneath the closed wound. The x-ray that was taken is essentially worthless.

Although I have a laser in my office, I no longer use them to treat warts as I find them to have a low success rate. I would hope the podiatrist would have "carved" out the wart prior to lasering it. If he did carve it out then if there is no foreign body underneath the wart, the area should have felt better for a period of time; if he did not carve it out then there less likely a way to know if there is anything underneath the wart.

My approach would probably be to put the area to sleep and excise the total wart for the simple reason I could then inspect underneath and see if there is anything else going on like sand, glass, etc.

You could also consider an ultrasound as well if you are not big on having surgery on your son's foot at this time, but it may come to excision anyway because the laser does not appear to be working and your son is having pain walking on it.

Marc Mitnick DPM

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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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Wonderful advice

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North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

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Florida

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New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

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Bellevue, WA

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Jodi

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Ball of foot pain.

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