What causes pain in the site of bone grafting?
Patient: I fractured my foot and ankle slamming directly into a piece of wood in September of 2010. The fifth metatarsal fractured at the distal head and was quite significant. I was treated with a boot, and told I did not need surgery. The metarsal was slow to heal but the ankle healed and the other fractures. Last x-ray in November and December showed a healed fracture. I began having pain and swelling in April and May of 2011. X-rays revealed a bone mass in the fracture site which had characteristics of a tumor. Emergent surgery was performed, a bone graft completed (taken from heel), and biopsy and cultures were clean. I am 13 weeks status-post surgery, and recently began to have significant pain in the graft site. Is this normal? If the site is a non-union, what is the next step? Doctor: Hello,  Bone has no nerve supply,its is the covering of the bone( perosteum,) that has sensory nerve supply.  So after bone grafting when overlying breached periosteum develops newer nerve endings which are highly sensitive as they are un myelinated and are responsible for pain.  Hope I have answered your query. Let me know if I can assist you further.  Take care  Regards, Dr. Rohan Shanker Tiwari