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Metatarsalgia caused by scaring

Discussion in 'Ask your questions here' started by Unregistered, Jul 4, 2009.

  1. Unregistered

    Unregistered Guest

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    Due to an incomplete healing of the surgical wound I have a 1 inch scar directly on my right metatarsal that forms keloids and becomes a hard, almost plastic like knob of dead skin that causes pain when walking or standing if allowed to build up. Feels like walking on a pebble. Using a blade to revise the scar provides relief for a few days to weeks. After heavy use of the foot e.g. a short run, not only is there pain during the impact of the right foot during the run but there is further pain at the internal tissue level once a resting position is assumed. The pain feels like a blade being pushed into the former wound.

    It’s been more than 10 years that my active lifestyle has been curtailed by this problem. An accident to my right foot from direct impact on broken glass resulted in the need for an orthopedic wound exploration a year later to remove glass fragments that were left inside during the ER administered emergency stitching applied when first treated for glass cut foot.

    The sutures were removed probably too early for the surgical wound split open during the following 48 hours. There was no scar management at that time and a bandage was provided to wrap up the wound and elevation ordered for the next few days.

    The wound eventually healed but when the scab fell off it was discovered that I had loss the use of my right big toe and there was a keloidal growth at the point of rupture. Initial management was to treat with show insoles designed by a podiatrist and to self administer the scar revision using appropriate blades.

    Subsequent treatment
    A plastic surgeon suggested long term application of betametasone and momometasone in conjunction with scar revisions. 3 years have passed with no permanent results. Only a longer interval between each need to cut off the scar tissue.

    A plastic surgeon suggested a cream mixture of salicylic acid and Vaseline. Where possible to applied thickly in conjunction with direct salicylic acid to the affected area. 3 years passed with no permanent results.

    A podiatrist and an orthopedic suggested high density foam inserts used in conjunction with molded plastic inserts to transfer weight away from the metatarsal. This method was more limiting in terms of restricting daily activity as it required special shoes to be worn at home instead of the normal moving about barefoot. The keloid growth would eventually fill the shape of the cut-out in the soles and then start to produce pain when walking. A further problem developed with foot fungal issues as the skin never had a chance to breathe. By re-aligning the weight distribution there was significant knee joint pain experienced after 9 months and grew worse with each passing month. Joint pain subsided with the removal of inserts, though never fully healed. This option was discontinued after 4 years.

    Desired results
    Would like to find a treatment that ideally would cause no disruption to current lifestyle because I need to be on my feet a lot such as to deliver presentations and speeches. However the entire scar would be managed until it is indistinguishable to the untrained, naked eye from normal skin. Keloid growth would cease permanently, even when taking part in the more intensive activities such as running.

    Which doctor has had similar experience and knowledge of this case? What can I do to regain my full range of activity?
  2. FootDoc

    FootDoc New Member

    Clearly your situation is far to involved for you to have any expectations of a meaningful reply without a hands-on examination, especially in a forum venue. I would tend to think that a plastic surgeon was and would be the most appropriate to consult.

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