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Type two diabetes patient. Fell down and have an abrasion on the outside of thigh. Should I be worried?

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General & Family Physician
Practicing since : 2005
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My brother, 68 years old, has Type Two Diabetes and suffered a fall two weeks ago which caused an abrasion on the outside of his thigh, a large bruise, and a hematoma. He saw a doctor who said the "envelope had not ruptured and prescribed Keflex incase of infection. My brother says the hematoma still feels hard and aches and that the bruising has shifted position, from the outside of the thigh to behind his knee. He doesn't think he needs to see the doctor again, but I'm concerned. Can you please advise? Thank you. Sorry, I don't have any pictures or reports.
Posted Wed, 20 Nov 2013 in Diabetes
Answered by Dr. Prasad 1 hour later
Brief Answer: Need clarification... Detailed Answer: Hi, I understand your concern. Diabetes and injury can become bothersome if not addressed rightly. However based on my experience, if there is no significant skin breaking, the chances of infection is least. Based on your description, he has minor broken skin in form of abrasion along with intradermal / subcutaneous collection of blood. At this point of time, I would like to know a few important aspects: 1. How are his blood sugars currently? Has he got them checked recently? If yes are the sugars in control? 2. How is the wound healing now? Is the abrasion wound spreading / healing? Is there any form of discharge from it? 3. Has a fracture being ruled out through X-rays? If X-ray was not done, I would like to know if he can stand and walk around without significant pain / difficulty? 4. Is he running fever? Please provide the following details and we can discuss about this concern further. Regards
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Follow-up: Type two diabetes patient. Fell down and have an abrasion on the outside of thigh. Should I be worried? 22 hours later
Dear Dr. XXXXXXX Thank you for your advice. In answer to your questions: 1. Yes his blood sugars are under control and both he and his doctor check them regularly. 2. The abrasion is healing and there is no discharge. 3. An X-Ray was done at the time of the fall and there was no fracture. 4. No he is not running a fever His only concern is a dull ache in the area of the abrasion and it appears that the bruise has moved/expanded down his leg to the area behind his knee cap. Is this cause for concern? Thank you, XXXXXXX
Answered by Dr. Prasad 44 minutes later
Brief Answer: No, I wouldn't be concerned. Detailed Answer: Dear XXXXXXX Thanks for providing the additional details. I am glad fractures are ruled out and the external wound is healing well. Subcutaneous collection including blood moves down with the effect of gravity. It will settle down at the dependent area. I wouldn't be concerned if the dull ache is tolerable and there are no signs of inflammation (tenderness, swelling, local rise of temperature). In this instant, I would suggest limb elevation and ice therapy. Avoid pain killers especially aspirin if pain is not severe. Watch out for signs of inflammation as described above. You can consider a visit to a doctor if inflammatory signs develop. Hope this helps. Let me know if you need clarifications. Regards
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