How extra bone can cause slow wound healing.

In this podcast I’m talking a little bit about how to bones or accessory bones can cause increased pressure and wounds on the bottom of the foot I’ll explain a little bit about how removing it maybe necessary. If you promise helpful you can get your free 10 week course on wound healing at

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Dr. Donald Pelto

Hi. This is Dr. Donald Pelto. I would like to talk this week about how extra bone sometimes can cause poor wound healing. There was a patient that came into the office this week that had a sore underneath the ball of the foot, more on the outside, and it was caused initially by wearing a dress shoe that was too tight. He developed a callous, and that callous blistered up underneath the side of his foot. It was underneath actually what we call the fifth metatarsal head. Over the last few weeks, the sore has healed up and there is just a callous on top. But the concern for this patient with diabetes is that this wound will open up again. When I was able to look at an x-ray, I actually saw that he had an extra piece of bone underneath that bone. That is called an accessory ossicle. What that means is it is pretty much a little extra piece of bone that is underneath that bone and some of the other bones in the foot. But the problem with it is that that little extra bone puts extra pressure underneath the bottom of the foot when he is walking, creating a callous, and that creates an ulcer. One of the treatment options for healing this is to actually go in there and pluck out that little extra piece of bone that is causing the problem. This idea of extra bone, or bony prominence as we call it, can happen on different parts of the foot; for example in the middle of the foot if someone has a broken or collapsed foot caused by Charcot. That extra bone can cause the sore and that may need to be planed or shaved off to help with that. Also, between the toes very commonly people get sores between the toes or callouses between the toes. We call them kissing callouses or kissing corns. It is actually because the two pieces of bone there have little bone spurs that can pinch each other and cause a little bit of a sore or callous. If that is not treated, it can cause a sore that can go into the bone very easily. So that is a little bit about how extra bones can cause sores.