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Ankle rolled. Foot swollen. Sprained ankle and tendon damaged. Is it possible that this is more than a sprain?

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I missed the last step on a staircase 5 days ago. I was not wearing supportive shoes and my ankle rolled. (I honestly don't know which way, but I assume in). I was not able to put weight on it, so I went to the ED. My foot was very swollen along the outside of my foot and was slowly bruising. In the ED they took x-rays of my foot and ankle and told me that I had sprained my ankle with possible tendon damage. They gave me and air cast brace (which I still can't wear due to swelling and the pressure it puts on my foot) to be worn for 2 weeks and crutches to be used as needed, but to bear weight as soon as possible. They also gave me strong pain killers to use as needed.

It has now been 5 days and I still cannot bear weight. My foot has entirely bruised (all around my ankle and up to my toes, with a darker purple bruise along the outside of my foot). It is still extremely swollen and tender. I cannot bend it very far up or in. There are two bumps which are more tender than the rest of my foot, one on the top of my foot and one mid-way down on the outside of my foot.

Is it possible that this is more than a sprain? I do not want to do more damage to my foot if it is something more, but at the same time I do not want to over-react.

Thank you for your advice
Posted Fri, 30 Aug 2013 in Bones, Muscles and Joints
Answered by Dr. Grzegorz Stanko 14 minutes later

Thank you for the query.

Bruises, swelling and tenderness of your foot may be caused by blood accumulation in the soft tissues. It is usually caused by veins rupture and gives symptoms couple days after the trauma. Such blood accumulation leads to other tissues compression and its ischemia. In some cases ischemia can cause tissues necrosis.
Veins thrombosis can also give such symptoms and can be caused by trauma as well.

I suggest you to visit general surgeon for physical examination. In case of doubts, soft tissues ultrasound should be done. General surgeon may decide to make some incisions in the painful area so the tissues wont be compressed anymore.

If you can, please attach a photo of your foot so I can give more accurate answer.

Hope this will help. Feel free to ask further questions.
Above answer was peer-reviewed by
Follow-up: Ankle rolled. Foot swollen. Sprained ankle and tendon damaged. Is it possible that this is more than a sprain? 10 minutes later
Thank you very much for your answer.

I would be happy to attach pictures but I'm not sure how.
Answered by Dr. Grzegorz Stanko 31 minutes later
There should be an option in this query. If you cannot find it, please sed the picture to YYYY@YYYY and XXXXXXX it for query no. 0000.

OK, I have your pictures. It does not look bad. It is swelled indeed, but the bruise is only in few areas. And it seems that incision is not necessary right now.

Here is what you should do:
- try to avoid putting weight on it for few days, do not walk too much
- when lying down, put your leg a little bit higher (put a pillow under your foot)
- if the swelling and the pain will start to improve in next two days, no medical attention is necessary
- if the pain and/or welling wont go away, you will start to have fever, the pain will get stronger, please consult general surgeon

Hope this will help.
Above answer was peer-reviewed by
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