Persistent Ankle Injury After Accident: Treatment Options and Recovery

Ankle laceration from a car accident, slow to heal after sutures were removed?

Hello, Doctor.
I had a car accident in 2013, resulting in a laceration to my left ankle.
I was taken to the emergency room where the wound was sutured.
A few weeks later, the stitches were removed, and since then I have seen an orthopedic surgeon with no issues found.
I have also undergone acupuncture and cupping therapy with traditional Chinese medicine.
However, the wound still has a slight indentation, and it is painful when pressed.
Walking does not significantly affect me, but I feel tightness around the ankle and just below the calf.
The traditional Chinese medicine practitioner mentioned that there might be some fibrosis near the wound, or it could be an issue related to the depth of the initial suturing.
I would like to ask the doctor what treatments you would recommend at this point.
Given the time that has passed, would you suggest seeing a Western medicine specialist for surgery, or should I continue with traditional Chinese medicine treatment?

Mr. Chen, 20~29 year old female. Ask Date: 2016/10/10

Dr. Li Zhonghuai reply Surgery

Hello! It sounds more like a hypertrophic scar.
There is no wound, so there's no need to worry about it.
The symptoms become more pronounced with pressure.
Take care! Changhua Hospital is concerned about you!

Reply Date: 2016/10/10

More Info

It sounds like you have been dealing with a persistent ankle injury since your car accident in 2013, which has led to ongoing discomfort and concerns about the healing process. Given the complexity of your situation, it’s essential to approach your recovery with a comprehensive understanding of both Western and traditional Chinese medicine (TCM) perspectives.

Understanding Your Condition
From your description, it seems that you have experienced a significant injury that resulted in a laceration and subsequent scarring. The fact that you still have pain upon pressing the area and a feeling of tightness in the ankle and lower leg suggests that there may be underlying issues such as scar tissue formation or possible fibrous tissue development around the injury site. This can happen when the body heals from a deep wound, leading to fibrosis, which can restrict movement and cause discomfort.

Treatment Options
1. Physical Therapy: Engaging in physical therapy can be beneficial for your recovery. A physical therapist can provide targeted exercises to improve flexibility, strength, and range of motion in your ankle. They may also use modalities such as ultrasound therapy or electrical stimulation to help reduce pain and promote healing.

2. Scar Management: Since you mentioned the presence of a depression at the injury site, scar management techniques may be helpful. This can include:
- Silicone Gel Sheets or Silicone Gel: These products can help flatten and soften scars over time.

- Massage Therapy: Gentle massage around the scar tissue can help break down adhesions and improve circulation to the area.

- Pressure Garments: In some cases, wearing a pressure garment can help reduce the appearance of scars and improve the overall texture of the skin.

3. Injections: If the pain persists and is significantly affecting your quality of life, you might consider discussing corticosteroid injections with your physician. These can help reduce inflammation and pain in the affected area.

4. Surgical Options: If conservative treatments do not yield satisfactory results, and if the pain is debilitating, you may want to consult with an orthopedic surgeon. They can evaluate whether surgical intervention is necessary to address any structural issues, such as removing scar tissue or repairing any underlying damage.

5. Continued TCM Treatment: Since you have been receiving acupuncture and other TCM treatments, it may be worthwhile to continue these therapies. Acupuncture can help alleviate pain and promote healing by improving blood flow and reducing inflammation. Herbal remedies may also support your recovery, but it’s essential to consult with a qualified practitioner who can tailor treatments to your specific needs.

Monitoring Your Progress
It’s crucial to keep track of your symptoms and any changes you experience. If you notice increased pain, swelling, or changes in mobility, it would be wise to seek further evaluation from a healthcare professional. Regular follow-ups with both your Western medicine provider and TCM practitioner can help ensure that you are on the right path to recovery.

Conclusion
In summary, your persistent ankle injury requires a multifaceted approach to treatment. Combining physical therapy, scar management techniques, and possibly further medical interventions can help you achieve better outcomes. It’s essential to communicate openly with your healthcare providers about your concerns and progress, ensuring that you receive the most appropriate care for your situation. Remember, healing takes time, and being proactive about your recovery is key to regaining full function and alleviating pain.

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