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The response to the question below was authored by Marc Mitnick DPM
stepped on glass
laceration on bottom of foot
Last night I stepped on a good size piece of glass. The laceration in the dead center of my foot by the arch, it bled a lot but I cleaned it and applied pressure. My question is that now today I cannot stand on it at all and if my foot moves at all the wound pulls apart, not bleeding but a shocking pain. Do I need to get it looked at or just keep it clean etc?
There are a couple of issues to consider here.
The first and possibly most obvious is whether or not there are any remaining pieces of glass in your foot. You mention that you stepped on a good size piece of glass and I assume you removed it. The problem here is since it was broken glass to begin with, there is always the possibility that part of that "good size piece of glass" is still in your foot.
The only way to know for sure is for a doctor to probe the area or perhaps perform an ultrasound which will usually show any kind of foreign body. Just so you know, an x-ray is not the best way to determine if there is glass in your foot. I mention it just in case you go the emergency room or elsewhere and they want to take an x-ray.
The bigger issue then becomes how deep is the wound on the bottom of your foot. Stating the obvious, the deeper the wound, the more damage you may have done to your foot.
The largest, most superficial part of your foot in the arch area just below the skin is the plantar fascial ligament. This is a long ligament that extends from your heel to the ball of the foot. Its purpose to maintain the congruity of the arch, meaning it works like a bow string to keep your arched raised.
If the glass penetration was deep enough, it could have cut into the plantar fascial ligament and thus every time you attempt to stand on the foot, you are stretching a torn ligament which can be very painful.
If it is partially torn and not adequately treated you could end up with scarring of the ligament which may end up being a constant source of pain especially if you are athletic or spend a lot of time on your feet.
The cut in the skin itself is also an issue. As you have already noted, every time you stand up you seem to be pulling the wound apart. That is because there is tremendous pressure on the skin on the bottom of the foot and for that reason the skin on that portion of the foot is prone to scarring.
In surgery when we do incisions on the bottom of the foot, we usually leave the stitches in longer than usual and will almost always have the patient nonweightbearing on the foot for at least three weeks, to give the incision adequate time to heal.
So you can see there are a few considerations to take into account. It would be my suggestion to seek medical attention to have the wound adequately evaluated and to deal with any potential issues that I have just described. The fact that the wound keeps pulling apart when you stand does concern me.
Additionally, you will want to make sure your tetanus vaccines are up to date.
Marc Mitnick DPM
Johns Hopkins Medicine
University of Rochester Medical Center
American Academy of Pediatrics
Penn State Medical Center
National Institutes of Health
Columbia University Department of Rehabilitation
Stanford Health Care
Illinois Bone and Joint Institute
Mount Sinai Hospital
Institute for Chronic Pain
University of Florida Health
American Family Physician
University of Maryland Medical Center