Post-Accident Ankle Swelling: When to Seek Medical Attention?

Q: Post-Accident Ankle Swelling: When to Seek Medical Attention?

Hello! 1. <br>The wound is still swollen： The photo of the outer ankle shows that the wound is still dirty, and the elbow hasn't been cleaned properly, which is why there is so much scabbing. <br>2. <br>Whether there is any pus inside can only be determined through a clinical exa

Swelling of the lateral malleolus persists after the car accident?

Hello Doctor, I had a motorcycle accident two weeks ago, during which my right ankle was crushed, resulting in a wound approximately 2x2.5 cm on the lateral malleolus.
After the emergency physician performed debridement, I was prescribed oral anti-inflammatory medication and a topical ointment called Persin to take home for recovery.
A few days later, I visited a nearby orthopedic clinic, where the doctor informed me that the wound was infected, so I received an injection of antibiotics and a week’s worth of oral medication.
However, it has now been two weeks since the accident, and I have finished the oral medication and ointment, but there is still some swelling present.
It is not painful, but I feel a sensation of swelling as if something is stuck when walking.
Occasionally, at night, I experience slight tingling or aching pain due to the swelling.
1.
I would like to ask if I need to return for a follow-up examination since the wound has not yet reduced in swelling after two weeks since the accident?
2.
Is my wound considered a "golden" wound?
3.
I also have a wound on my right elbow that is healing quite rapidly, but since the day before yesterday, I have experienced a dull pain in the right shoulder joint when raising my arm to certain positions, while other positions do not cause pain.
I am concerned about the possibility of developing cellulitis, but there are no signs of swelling or pain at the site of the wound on my arm.
What recommendations do you have?
Thank you for your patience in reviewing my concerns.
Below are the links to the wound photos:
Lateral malleolus wound: https://imgur.com/a/fpQlI
Close-up of lateral malleolus wound: https://imgur.com/a/5dyWA
Comparison of both ankles: https://imgur.com/a/zijoF
Elbow wound: https://imgur.com/a/xNCDx
Position causing pain when raising the arm: https://imgur.com/a/Pyw5b

Awei, 20~29 year old female. Ask Date: 2016/08/13

Dr. Li Zhonghuai reply Surgery

Hello! 1.
The wound is still swollen: The photo of the outer ankle shows that the wound is still dirty, and the elbow hasn't been cleaned properly, which is why there is so much scabbing.
2.
Whether there is any pus inside can only be determined through a clinical examination, so you still need to return for a follow-up.
3.
The elbow hasn't been cleaned well either, but at your age, your immune system is fine; once the scabs fall off, there shouldn't be any issues.
Occasional sharp pain within three to six months is normal.
Take care! Changhua Hospital is concerned about you!

Reply Date: 2016/08/13

More Info

After a car accident, it's common to experience swelling and discomfort in the affected areas, especially if there was direct trauma to the ankle. Based on your description, it sounds like you have been following appropriate medical advice, but there are still some concerns that need to be addressed.

1. Persistent Swelling: Given that it has been two weeks since the accident and you are still experiencing swelling, it is advisable to return to your healthcare provider for a follow-up examination. While some swelling can be normal after an injury, especially if there was significant trauma, persistent swelling could indicate complications such as lingering inflammation, fluid accumulation, or even a possible fracture that may not have been detected initially. Your doctor may want to perform imaging studies, such as an X-ray or ultrasound, to assess the condition of the ankle and ensure that there are no underlying issues.

2. Wound Assessment: The term "金包銀" (literally "gold wrapped in silver") typically refers to a wound that is deep and may have underlying tissue damage, even if the surface appears to be healing. If your wound is healing well on the surface but you are experiencing swelling and discomfort, it is essential to have it evaluated to rule out any deeper infection or complications. Signs of infection include increased redness, warmth, discharge, or worsening pain, which you should monitor closely.

3. Shoulder Pain: Regarding the pain in your right shoulder when lifting your arm, it’s important to differentiate between shoulder joint issues and referred pain from your elbow or wrist. Since you mentioned that your elbow wound is healing quickly and there are no signs of infection, the shoulder pain could be due to muscle strain or overuse, especially if you have been compensating for your ankle injury. However, if the pain persists or worsens, or if you notice any swelling or changes in the shoulder joint, it would be wise to consult with your healthcare provider. They may recommend physical therapy or further imaging to assess the shoulder joint.

In summary, here are some recommendations:
- Follow-Up Appointment: Schedule a follow-up visit with your healthcare provider to assess the swelling in your ankle and the condition of your wounds.

- Monitor Symptoms: Keep an eye on any changes in your symptoms, such as increased pain, redness, or discharge from the wounds.

- Shoulder Pain Management: If the shoulder pain continues, consider rest and gentle stretching, but do not hesitate to seek medical advice if it does not improve.

Injuries can sometimes have delayed effects, and it’s always better to err on the side of caution when it comes to your health. Your healthcare provider will be able to give you the best advice tailored to your specific situation.

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