Hi, Was In A Car Accident 2.5 Months Ago And

Posted on Wed, 25 Sep 2019

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Wed, 25 Sep 2019 Answered on

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Question : Hi, was in a car accident 2.5 months ago and injured my right foot. I was the driver in a rear end collision (low speed) but my foot got jammed on the brake pedal and was forced back on impact. I was taken to the ED where xray shows I did not sustain a fracture, but I did have a grade 3 ankle sprain and obvious midfoot injury. There was significant swelling and bruising on my foot and ankle. I was unable to walk for about a week and was on crutches, then progressed to a boot and then finally an ankle brace. The swelling and bruising resolved within about a month, however, I still have significant pain in my midfoot. I was initially told there may or may not be nerve damage due to my big toe being numb right after the injury, and now I'm experiencing shooting pain occasionally in that midfoot area that radiates to my toes. Additionally, I have obvious, hard prominence on the top of my foot that wasn't there prior to the injury. I was curious what this could be from, as my xray didn't show anything and it's hard so it's not like the edema I experienced that eventually resolved. The area is painful when pressure is applied and I've been having to take NSAIDs quite frequently, especially when I've been on my feet for a while which worries me because I don't want to risk a GI bleed. I'm not sure what I can do to help heal this injury because it's not something I can splint and it doesn't seem to be getting any better. Thank you.

Note: I uploaded pictures of both feet for comparison

Follow up: Dr. Dr. Praveen Tayal (0 minute later)

Hi, was in a car accident 2.5 months ago and injured my right foot. I was the driver in a rear end collision (low speed) but my foot got jammed on the brake pedal and was forced back on impact. I was taken to the ED where xray shows I did not sustain a fracture, but I did have a grade 3 ankle sprain and obvious midfoot injury. There was significant swelling and bruising on my foot and ankle. I was unable to walk for about a week and was on crutches, then progressed to a boot and then finally an ankle brace. The swelling and bruising resolved within about a month, however, I still have significant pain in my midfoot. I was initially told there may or may not be nerve damage due to my big toe being numb right after the injury, and now I'm experiencing shooting pain occasionally in that midfoot area that radiates to my toes. Additionally, I have obvious, hard prominence on the top of my foot that wasn't there prior to the injury. I was curious what this could be from, as my xray didn't show anything and it's hard so it's not like the edema I experienced that eventually resolved. The area is painful when pressure is applied and I've been having to take NSAIDs quite frequently, especially when I've been on my feet for a while which worries me because I don't want to risk a GI bleed. I'm not sure what I can do to help heal this injury because it's not something I can splint and it doesn't seem to be getting any better. Thank you.

Note: I uploaded pictures of both feet for comparison

Answered by Dr. Dr. Praveen Tayal (4 hours later)

Brief Answer:
Can be a hematoma or infection.

Detailed Answer:
Hello,
Thanks for posting your query.

I have checked all the attached images. The swelling that you have mentioned is not related to any bony abnormality.

This can be a hematoma that has not yet resolved completely. Since the area is painful an infection needs to be ruled out after a direct examination.

You can get a CT scan or MRI scan of the area done to be sure regarding the nature of the swelling. In case there is no infection then it should gradually resolve in the next 3-5 weeks.

I hope this answers your query.

In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.

Wishing you good health.

Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Answered by Dr. Dr. Praveen Tayal (0 minute later)

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Praveen Tayal (37 minutes later)

Dr. Tayal,
Thank you for your reply. Is it normal for a hematoma to last this long? Is this possibly a bone contusion? Initially, the entire dorsum of my foot looked like a huge hematoma, but that resolved within 2-3 weeks. Thank you again, I’ll look into getting a CT or MRI.

Follow up: Dr. Dr. Praveen Tayal (0 minute later)

Answered by Dr. Dr. Praveen Tayal (12 hours later)

Brief Answer:
Hematoma can undergo fibrosis.

Detailed Answer:
Hello.
Thanks for writing again.
A hemtoma can undergo fibrosis and can become firm and persist for long. A bone contusion is less likely. An MRI scan will help in further confirmation.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Yogesh D