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Suggest Treatment For Multiple Tibia Fracture

Posted on Tue, 26 Jul 2016

Question: Fractures tibia in 3 places. At the same time of fracture toes numb, don't feel like they are mine. Feel pressure, swelling, an toes are darkening. Ankle, and now calf is swelling. Indents when touched. Wet spongy sensation like a wet sock. Have seen Ortho (who took care of knee) and another Ortho and Primarycare and no one will address the foot. Broke one yr ago. cruising wheel chair which is becoming a muscle problem in legs, groins, hips and back. What do I do? Where do I go. Pain, pressure swelling is ridiculous. XXXXXXX

Answered by Dr. Dr. Naveen Kumar Sharma (4 hours later)

Brief Answer:
I need some detail of your illness

Detailed Answer:
Hello, I have studied your case and I think you may be having neuropathy. Before I advised you anything I would like to know little detail of the illness.
1. Are you able to walk?
2. Do you have smoke or have diabetes?
3.Do you have any ulcer over feet?
Please send me answers for these questions. I will try my best to help you. Thanks

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Naveen Kumar Sharma (1 hour later)

Hello Dr. XXXXXXX No, I haven't walked for a year since I originally fracture tibia in 3 places just under plateau. That healed but at the same time I kept telling them I couldn't feel my toes and at the time if felt like a fake toes was strapped on my foot. Still have a "band" feeling around my foot.
Toes are swollen, foot gets to 35cm and ankle swells to 37 cm and calf swells to 15". Pitting with pressure.
Pressure , aching, burning, searing pain alternately.
Ortho fixed knee and took xrays of foot and bone structure is fine. PT said it looks like RSD but Primary care said no.
Dopplar showed not blockage up to hip.
No smoking not tested for diabetes but.....No ulcers or open sores...
Toes darkening..I have a couple of pics. Thanks for your time. No one else seems to know where to send me.

Answered by Dr. Dr. Naveen Kumar Sharma (2 hours later)

Brief Answer:
You are having RSD

Detailed Answer:
Hello,
I have studied your case. I think you are having RSD. In this condition there is nerve stimulation following trauma or fracture. It causes severe burning pain in limb with difficulty in walking. I have following suggestions for you.
1.get EMG/NCV to see if there is any nerve related problem like nerve compression.
2.hot water fomentation and wax bath is useful.
3.continue physiotherapy.
4.tablet Pregabalin M is good for pain. You can take 10 mg amytryptalin also. These medicines are available on prescription by a doctor.
Once you have done with EMG report you can share that with me.
I would also like to see pictures of your limb. Thanks

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Naveen Kumar Sharma (12 hours later)

Hello, I sent two pics to you of foot. It gets even bigger than time of pic. I will check in to this EMG/NCV...will get to PT a couple times a month. No ins. cash paying. Thank you for your time. Let me check on this test.

Answered by Dr. Dr. Naveen Kumar Sharma (17 hours later)

Brief Answer:
it can be RSD

Detailed Answer:
Hello,
I have studied your images. It can be RSD on the basis of these images also. Lets see what EMG/NCV report says. Any way continue with physiotherapy. If your nerves comes normal then there is no reason that you can not walk.
thanks

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar