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Fell from escalator needing stitches. No fracture. Having pain and swells occasionally. Had physiotherapy. Suggest

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Hi, two years odd ago, I Fell down an escalator and lacerated my leg to the bone the gash was approx 6-7 inches and required 23 big stitches. The injury was just below my knee at the front and I didn't have a fracture, but my leg gives me pain, my leg swells on occasion is tender to the touch like a bruise, yet has not got much feeling on the actual skin. Why am I still in pain. I have had physiotherapy, an x-ray has ruled out a tear to the knee, though there is early signs of wear and tear and I had a course of acupuncture at the hospital, none of which has helped. The gash was one side of my leg to the other and the bone was exposed but it is mainly the inside of my leg that is still tender and hurts if I stand or walk for too long.
Posted Sun, 30 Jun 2013 in General Health
 
 
Answered by Dr. Chobufo Ditah 1 hour later
Hi and thanks for your query.

I am so sorry about what you have been experiencing with you leg for all this while.
I feel privileged having this opportunity to assist in your health needs.

I am Dr. Ditah, a general physician. I will be helping you out today with this question.

1. "The injury was just below my knee at the front and I didn't have a fracture, but my leg gives me pain, my leg swells on occasion is tender to the touch like a bruise, yet has not got much feeling on the actual skin". Why am I still in pain

Big lacerations like the one you incurred often interfere with the vasculature of the leg(especially the veins) and the innervation. These veins are responsible for returning fluid from the leg back to the heart. Because their integrity has been tampered with, they can no longer be as efficient in executing this function as before. This explains why, you may notice some swelling mostly after standing or sitting for long periods. This should usually occur at the end of a busy day and normally disappears overnight. Physiotherapy often tries to restore the normal functioning of the affected body part but rarely does it get to 100%. Some of the normal functions get lost and are never fully recovered. Physiotherapy only ensures getting the best out a bad situation.

2."The gash was one side of my leg to the other and the bone was exposed but it is mainly the inside of my leg that is still tender and hurts if I stand or walk for too long".
The truth is, not all muscle/parts of the leg are used to the same extend when we walk or stand. The parts which is used more than the other determines where symptoms can easily develop. If the movements you make during these activities use more of this muscle group, then it will definitely hurt more than the others. Also, though you had a laceration, not all different muscles and structures were affected to the same degree and this may explain why some hurt more than others.

Having some residual pain after an accident like this at times is understandable. What we have to do is make sure that we rule out XXXXXXX lesions like you have already done and adopt measures to control your pains. Limiting movements that provoke or aggravate the pains, avoiding to stand for long or walk for long especially when not very important alongside taking some good pain medications can help. Please get your weight in the normal range for your height (BMI) to prevent provoking or aggravating this already existing problem if it is not the case.

Acupuncture works for those who believe in it, If you do and so deeply, then it will work for you. If you don't it wouldn't. It plays with the mindset rather than the core of the problem.

I hope i have answered your questions.
Feel free to come back if you require some more answers.
I wish you good health.
Dr. Ditah
Above answer was peer-reviewed by
 
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