Metatarsal Callus - Healing Time - Lab Info

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As a podiatry school intern many new questions arise from patients on how long does it take to heal from various foot surgery. I had a patient the other day that was a 54 year old male, non-diabetic, good foot pulse, 210 lbs. that had been seen for what was diagnois as a callus or wart. The patient had been using some over the counter acid treatment for what appeared as a wart therfore the clear identiy of is it a callus or wart was in question. Nevertheless the podiatrist I work with took a x-ray and stated it appears that you most likely had a wart due to the way the x-ray appeared?

What the podiatrist I was working with stated allow me to excise this area and trim it back to facilitate the healing and to look at the area better. The area once it was trimmed back was around 10 mm wide in a circular pattern and about 4-5 mm deep in the concave pattern. While he was working on this patient he stated that this area looks strange and took a bioposy which was negative for any maligancy.

The patient came in again and was healing fine at the two week point. Patient ask how long will it be before the soreness goes away from this trimming. Podiatrist stated around 8-10weeks---- does this sound normal???? My vote is yes--- what is your thoughts? Since this guy I am working with in training is very tight lip on helping you understand I pose this question? - On the biopsy can they determine if the tissue is callus or a wart? Please help me on understanding this process better -- THANKS

 

You can't see a wart on X-Ray.

 

Hi timbogates,

Not entirely sure what you are asking ? Histology can determine whether there are viral particles present (wart), or not (callus), in the sample taken.

Why were x-rays taken?

Cheers,
Bel

 

yes I do agree he does some interesting additional testing. What are your thoughts on the healing time and residual soreness. He describes it as a feeling like a bruise.

 

personally i would procede with caution if biopsing over a high pressure WB'g area such as on a MTPJ. This can cause endless sensitive callous if nerves have been exposed . You haven't said where the lesion was...

 

That horse bolted .....

 

i always was slow to reply Mr Moderator

 

This is located between the 2 and 3 toe on the metatarsal pad. If the patient heals good - should soaks be recommended to help on the residual soreness? How long do you think he will have the residual soreness -2-4 months. If 4-5 months out and residual soreness present -- orthotics? How about MRI?