This is a four year old paint with a laceration at the bulb of the heel at a depth that the nerve and blood vessels
were cut on the medial side and the laceration extended to the coronet band on the lateral side.

Any time you have a wound of this depth in this location, you have to anticipate that the lower nerves have
been lacerated and exposed. In order to treat this area, it may be necessary to start with lidocane to
desensitize the area. Our approach was to flush lidocane into the wound site followed by q-tips saturated in
wound wash to remove necrotic tissue from the inside bottom of the wound.

This injury was totally healed in 36 days with no overgrowth of granulation tissue (proud flesh), and the leg
was never cast.

The healing rate which was unusually fast in this case was attributed to 2 factors.  One – It was a white
pigmented foot and it has been our experience that white pigment heals faster.  Two – due to the angle of the
cut, we were able to inject the Platelet Derived Growth Factor directly into the lesion and it remained trapped
at the location.  Due to our bandaging technique we were never confronted with granulation overgrowth
which is quite often a problem in this area.

Treatment started 12-26-2002
Day 16
Day 11
Day 7
Day 1
Day 32
Day 36
Day 25
Day 20
Case 50
Bulb of Heel / Coronet Injury
Click on the photos to enlarge the view.
         Before         &        After