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Case Query - Trauma

Discussion in 'General Issues and Discussion Forum' started by Mark Russell, Jan 8, 2006.


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    Patient, mid forties, male, slipped in bathroom and impacted tibia just below knee against corner of bath three weeks ago. No cuts or abrasion, but the following day it became swollen, contused and painful. Within three days the lower leg was bruised heavily, extending into the medial arch and hallux. Within five days the ankle was oedematous and the bruising persisted, especially on the foot.

    Today, the leg is still painful at the trauma site, swollen with a hard mass approx. 5cms by 3cms, which reduces with pressure and return when released. Only a small amount of bruising on foot but the ankle is still oedematous and the tibia tender to touch down the shin.

    Any ideas?
     
  2. Depending on the anatomical location of the trauma (i.e. where exactly on the tibia was the trauma, superior or inferior to the tibial tuberosity?), this could either be a hematoma that needs to be drained, could be intra-articular edema or could simply be prolonged muscle swelling from blunt trauma. In my opinion, a set of radiographs are in order to rule out osseous pathology along with a referral to an orthopedic surgeon for definitive care. If it is a hematoma, early evacuation will help prevent it from consolidating into a persistent soft tissue mass.
     
  3. John Spina

    John Spina Active Member

    This sounds like a contusion lower leg.I would monitor it and if there is no improvement,you may need toremove the contusion.
     
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