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Ask Dr. Hasan Your Own Question

Dr. Hasan
Dr. Hasan, Doctor
Category: Medical
Satisfied Customers: 8396
Experience:  MBBS, FCPS, with experience in all fields of medicine and surgery
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I have my daughter who is 8 years old, she stepped on a glass

Customer Question

I have my daughter who is 8 years old, she stepped on a glass that cut her feet from the lower top just about under her toes in 5 cm. the dr said the injury is to deep which cut three layers of the skin and they made her stitches and when the neurology dr checked her and tickled her toes she said that she don't feel two fingers so he decided to do an operation but from the top part of her feet is this right? And does this diagnosis is enough to take her for operation? And what about the roes nerves, isn't she so young and it can heels by time?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Hasan replied 2 years ago.

Dr. Hasan :

Hi, Thanks for your question. I'm Dr. Hasan and I'll try to help you.

Dr. Hasan :

When exactly this happened?

JACUSTOMER-jcgicv2t- : Yesterday and the dr want to do an operation in four hours from now
Dr. Hasan :

Thanks a lot for your input.

Dr. Hasan :

I am sorry to hear about your daughters injury. I will address your concerns separately.

Dr. Hasan :

As per symptoms it is evident that the nerve supplying her toes has been cut.

Dr. Hasan :

Yes she definitely need operation to correct that cut.

Dr. Hasan :

and it should be done immediately because as time passes on, the chances of healing will significantly decrease.

JACUSTOMER-jcgicv2t- : Yes but how can they diagnose it with out anything except tickling
Dr. Hasan :

If done within time, she can come up with excellent results.

Dr. Hasan :

This is called clinical diagnosis. It is sufficient in this case. There are tests called nerve conduction studies but they are not absolutely required in this case.

Dr. Hasan :

Just not having the sensation are sufficient to go for operation.

Dr. Hasan :

It is sort of an exploration, they will look for the nerve and check if there is any cut. If there is a cut they will stitch it and if there is just a compression they will relieve it.

Dr. Hasan :

It is absolutely necessary.

JACUSTOMER-jcgicv2t- : Ok i got this but why he will do it from the top
Dr. Hasan :

Because the passes from there to go to bottom of foot.

Dr. Hasan :

It is easy to find nerve from there than to go for bottom.

Dr. Hasan :

At bottom nerve is deep and healing of wound also gets delayed.

Dr. Hasan :

There is thick fascia under foot but at top, they can find nerve easily.

Dr. Hasan :

It is recommended to go from top in such cases because in every aspect it is best to go from there.

Dr. Hasan :

Her young age is a point in her favour for a better healing.

JACUSTOMER-jcgicv2t- : But the cut is very big from down and its easier to look at it from there
Dr. Hasan :

Even if the cut is big, it is difficult for them to find nerve from there.

Dr. Hasan :

There are lot many structures at bottom and fewer at the top, so finding nerve is easy at top.

Dr. Hasan :

She will not get a bad scar at top, so don't worry.

JACUSTOMER-jcgicv2t- : Ok so how can they know if the nerve is cut from the top and the injury is from bottom
Dr. Hasan :

She will be able to walk earlier if they go from top.

Dr. Hasan :

While finding a nerve, what they do is this that they locate the nerve from where it is easily locatable and that position is at top. From there they can follow the course of nerve till the end.

Dr. Hasan :

It is standard protocol to find the nerve at easily accessible area and then to follow the course of nerve.

Dr. Hasan :

If they go from bottom, it is more likely that they will get stuck.

Dr. Hasan :

If they have one portion of nerve in their access and they don't find the other one, they can even put a nerve graft to solve the problem.

Dr. Hasan :

But if they just go from bottom, they might find one end and not the other so they will be in trouble.

Dr. Hasan :

What they have planned is accurate and recommended in such situations.

Dr. Hasan :

I assure you.

JACUSTOMER-jcgicv2t- : Whats a nerve graft
Dr. Hasan :

Nerve graft means that if they just find one end of nerve and not the other, they can take some nerve fibre from nearby area (where nerve supply is not important or there is other nerve nearby which can meet the requirements) and they can stitch that nerve to the main nerve to supply the toes.

Dr. Hasan :

You got my point?

Dr. Hasan :

You there?

Dr. Hasan :

I wish your daughter good luck for the surgery and wish that she gets well soon. My goal is to provide you with excellent service – if you feel you have received anything less, please reply back as I am happy to address follow-up questions. Kindly rate me when you are done. You can come back here to ask anything even after you have rated the answer. I will be glad to help you always.

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