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Scarring on dorsum of foot

Discussion in 'General Issues and Discussion Forum' started by jillian hosking, Jul 7, 2010.

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    I recently saw a 10yo boy who 7 years ago had the 2nd toes and extensor tendon to the 2nd toes, removed from both feet to construct a thumb and finger for his hand following an accident.

    The surgery has scarred the dorsum of his feet. He can wear Crocs and Dunlop Volleys without any problems but standard leather school shoes and joggers irritate the scarred skin .

    He is allowed to wear the Crocs and Volleys to school because of the skin problem but he develops foot pain when being active , ie school sports which he wants to participate in.

    A more supportive shoe is my first thought for reducing the foot pain.
    I tried different lacing styles with his current joggers to try to reduce/eliminate irritation to the scar tissue with no luck.

    Has anyone else ever encountered this problem. I was thinking of trying the Cica- gel product on the area as it is a red slightly raised scar.

    If any one has any ideas ,suggestions for padding materials or has used the Cica please let me know .

    Cheers Jill
     
  2. Hi Jill have you got some Photos ?
    Maybe one of the shoe folks maybe able to give you some better advice once they have seen the scar.
     
  3. Boots n all

    Boots n all Well-Known Member

    Get a pair of shoes the client is happy with then stitch the tongue to the upper down one side only, put some lipstck on the clients scare, bare foot of course, then put on and lace up the shoe.

    This will leave some lipstick on the underside of the tongue, that lines up with the scare, use some 4mm PPT or similar either side of the lipstick mark full width of the tongue, now when laced up the scare area is free from contact, the tongue been stitched down only one side means it wont move around and the client can still get the shoe on.

    The thickness of the PPT or even EVA will depend on how firm the shoe is laced up.

    Hope it helps
     
  4. Peter

    Peter Well-Known Member

  5. RobinP

    RobinP Well-Known Member

    David's suggestion is probably what I would do if it were an adult and the turnover of shoes was going to be limited.

    As it is a child, perhaps something along the lines of what Peter is suggesting might be better. Silipos (available through Langer UK) have some gel socks and other very useful adaptable things. This will help reduce the friction on the scar and should help the scar become less angry.

    http://www.silipos.com/002_prod/sub...4&subcat_id=13&subcat_name=Gel Gloves & Socks

    As far as footwear is concerned, It would depend on what size shoes the patient took. Orthopaedic trainers aren't great but the best of the bunch is Schein orthotic trainers. They are a little deeper than the average trainer and much stiffer.

    http://www.saltstechstep.co.uk/media/3655/salts-techstep-orthotic-and-support-shoes.pdf

    See page 11

    If your patient is big enough in size, trainers from Aetrex have up to 8mm removable inlays which may give a little leeway for reducing upper pressure on the scar. These can by ordered through P2D

    http://www.p2d.co.uk/

    However, they have a limited stock and I think they order in from the US directly from Aetrex. Click on this link for the Aetrex site.

    http://www.aetrex.com/#/mens/running/Z581M/

    Bear in mind that these are American sizes so the minimum UK size is 5 and a half

    Hope this helps

    Robin
     
  6. Craig Payne

    Craig Payne Moderator

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  7. RobinP

    RobinP Well-Known Member

    Sorry Jillian,

    Also didn't realise it was Australia. Not much of what i said will have any great relevance. Apologies. Maybe others will benefit.

    Robin
     
  8. Thanks Robin, Craig, Peter,Boots and m weber for your suggestions. Jill
     
  9. GarethNZ

    GarethNZ Active Member

    You might find that he has developed slight neuromas within the branches of the cutaneous nerve that supply the dorsum of the foot - the superficial peroneal.

    In adults I have found great success in injecting superfically a solution of 10% dextrose (superficial prolotherapy) around the scar site. I have tried this with post foot surgical patients that get burning and pain. I am using a botox size needle (30G) with good toleration.

    Let me know via email if you are keen to know more. (queenstownpodiatry@gmail.com). Glucose seems to repair connective tissue and reduce nerve inflammation which is what is happening here I would say.

    Cheers,

    Gareth
     
  10. footsiegirl

    footsiegirl Active Member

    Does the scar cause him any irritation at any other time...ie, is it itchy?
     
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