Hello. Thanks for asking from HCM.
I can understand your concern. As
bullet injury occurred from inside out, it might have caused medial plantar nerve injury or
tibial nerve injury just before bifurcation. It can only be confirmed by examination of your foot. Medial plantar
nerve damage cause sensory loss or tingling/burning sensation on medial plantar area between big toe and adjacent toe. There will be weakness of big toe and adjacent toe plantar flexion. In your case, most symptoms are resembling medial plantar nerve damage.
Now coming to your queries.
1. Severance or disconnection of nerve can be complete or partial. Partial disconnection can cause abnormal connection between nerve ends (
neuroma).
This can cause irritative symptoms like burning/tingling/insect crawling like sensations. Complete disconnection leads to loss of all sensations in affected region. Confirmation of it can be made by NCV/EMG studies.
2. It is right that partial injury has more chances of healing than complete injury. Presence of some sensation is considered a good sign. Nerve regeneration and healing in such cases can occur unto 18 months, but maximum healing occurs in first 12 months. Even surgical repair of nerve shows some good results in first 12 months.
But there is one problem. If irritative symptoms are severe and not decreasing even after medication, sometimes nerve is severed by doctor to relieve discomfort.
3. Walking or physical activity has nothing to do with healing of nerve. But it helps in stretching of muscles and acts like
physiotherapy, which is good for muscles supplied by the nerve. You can passively stretch your toes up and down. It also prevents permanent spasm or contracture of joints and thus
deformity.
Do not overdo it. It can damage muscle.
Some tips
-Do not take any medications for healing of nerves as after 1 year of injury, drugs do not enhance healing.
-Your are having small sized
peripheral nerve injury. Repair of such type nerve is very difficult and results are not very promising.
-You can take help of physiotherapist to learn about toe exercise.
Thanks. Hope it will help you. Take care