HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

What Causes Forearm Swelling Post Forearm Injury?

default
Posted on Tue, 27 Oct 2015
Question: One year ago I fell from a height of 3 meters. During the fall, with the full force of my body weight my arm banged and scraped against a metal beam. Immediately it swelled up and I was rushed to the hospital. I had no broken bones so they sent me home with my swollen arm as you see in the attached Original Injury photo. Now is one year later and my arm condition is worsening. My arm feels numb all day long. At night, my finger knuckles swell up and full of pain to the point I cannot bend my knuckles and takes me several minutes to gradually loosen them up. Are area of the injury has become more red than it was a few months ago and the tiny veins surround this red area are becoming more bright purple. My arm is feels warm and tight and the spot of the injury is very hard. I have been to a few doctors but not yet to a Vascular Surgeon or Specialist. Up until now, I've been told the only thing I can do is therapy. I have done some therapy off and on but condition never improved in the slightest bit and now just getting worse. I'm beginning to get very nervous and concerned my arm will further deteriorate and I don't even want to think of the worst case scenario. Based on this explanation and attached photos, I want to ask your opinion and to lead in the right direction to get further help. Thank you so much and please, if there is any further information or questions you need answered, please do let me know. Thank you, XXXX
doctor
Answered by Dr. Mukund Savaskar (5 hours later)
Brief Answer:
? Left Forearm Compression Syndrome /Under Investigation

Detailed Answer:
Brief Ans-? Left Forearm Compression Syndrome /Under Investigation
(as assessed from your updated photos)

Hi,Welcome for your query to HCM.
I studied the complex text of your query for the Forearm injury with compression of the forearm compartments with entrapment complaints of indefinite and complex nature which would multiple sessions to study your case.
As such, Based on the understanding of your last query data, I would suggest you-
a- to update a photograph of both of your forearms-
exposed from your shoulders to tip of your hand fingers from a distance of 2-3 feet,where I would get to know the condition of both the forearms of your hand
b-update photograph of the affected forearm only from 2-3 feet with exposure right from your shoulder till the tip of the hand with knuckles exposed.

Besides this please give more details how the whole complaint scenario
progressed from -at first 1 mth / 3mth/ 6 mth/ and at 9 mths and at 12 mths in brief if you can in short ,which would give me a chance to study your progress , and would help me to pinpoint areas ,which need to be stressed while advising a Primary plan of suggestions to begin with.

Hope you understand the importance of updating above 2 -4 sets of photographs of your affected and of both the forearms including from Shoulder to tip of the hand fingers and knuckles exposures from Front and from the back side of both and individual full upper arms.

Await your photos for the study and to review your case in next session.

Good Day!!

Dr.Savaskar, XXXXXXX Surgical Specialist
M.S.Genl-CVTS


Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Mukund Savaskar (15 hours later)
Dear Dr. Savaskar,

Please find attached four images.

The progression of my situation has been as follows:

1-month: Took almost a full month for the surface scabbing to fall off. Area was swollen and pins and needles feeling with pressing on area but not noticeably red.

3 month: Did not improve. Status was about same as after one month except just beneat the skin there began to feel and see small hardened-like bumps about the size of a rice kernal(s). When pressing on it, felt painful pins and needles.

6 months: Still no improvement but began to feel numbing of the arm and swelling fingers.

9 months. Still no improvement but sleeping becoming more difficult due to numbness and swelling and knuckles begin to hurt and they will stiffen up greatly during sleeping.

12 months: Now my knuckles hurt all day long and hand feels slightly swollen and injury area more profound red color and more visible tiny veins appearing near injury area. Pressing on area is still pins and needles. Numbness in arm and hand.

Please let me know if any other information or questions. Thank you
doctor
Answered by Dr. Mukund Savaskar (2 hours later)
Brief Answer:
? Left Forearm Compression Syndrome /Under Investigation

Detailed Answer:
Brief-Ans-? Left Forearm Compression Syndrome /Under Investigation

Hi,Thanks for the updates.
As asked in my last reply,I did not find one important photo of Both Forearms and arms with shoulders and hand.You might have missed it by oversight.

Would suggest you to update photo of Both Forearms,placed side by side to include area from shoulder to finger tips of both the arms from Front and from Back -to have a comparative study.
Await the above photo -inclusive of Both the Forearms as told above.
This is very important view,which was asked in my last reply.
If you want to update any further information(as old medicines scripts / and current medicines script- used ) please send it for the next session to be reviewed with the other photographs.
Hope to see you in for the next session.

Await your photos for the study and to review your case in next session.

Good Day!!

Dr.Savaskar, XXXXXXX Surgical Specialist
M.S.Genl-CVTS
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
default
Follow up: Dr. Mukund Savaskar (21 hours later)
Dear Dr. Savaskar,

Thank you for your patience. Attached are two photos comparing my arms both inside and outside (forearms). I hope this are okay.

Thank you,
XXXX
doctor
Answered by Dr. Mukund Savaskar (16 hours later)
Brief Answer:
Chronic Lt.ForeArm Compartment Syndrome(CCS of Left Fore Arm)/Under Invest.

Detailed Answer:
Brief-Ans-Chronic Lt. ForeArm Compartment Syndrome(CCS of Left Fore Arm)/Under Investigation

Hi,Thanks for the detailed updates on the query.
Sorry for keeping you in the waiting.
I studied all the photographs in context of your complaints of your query.
I meticulously tried to study the reasoning of your various complaints.

Your Undiagnosed Fore arm numbness and complaints are due to -

Chronic (Post-Traumatic Forearm Fascia Fibrosis )Venous Insufficiency/Congestion with Hypoxic Muscle edema,
- giving rise to –Chronic Fore-Arm Compartment Syndrome(CCS of Left Fore Arm)
which is the result of non- decompression of the Acute Compartment Syndrome of the Forearm,which you resolved with all the sufferings over first 6-12 mths,with resultant problems of Chronic Compartment Syndrome.

Suggestion Planning-
I would try to review and asses the case in next few sessions, as you interact with the Primary suggestions which would lead to more specific and fine-tuned suggestions over next few sessions.
Hence you have to have patience for interacting with suggested ways and plans, and updating your further info, so as to resolve your health issue to full satisfaction of yours,as it’s a very complicated and rare case to investigate and to deal with.

Further Information needed as follows-
I would need report of the CT of Left Forearm /Neve conduction reports and
Comparative Girth Records of both -the Right and left Forearm at 1 inch/ 2 inch below the elbow.

Any other test reports / of X-ray of Forearm/ CT of Forearm -if done would be needed for review and further planning.
Information on any anticoagulants given earlier period,to prevent Venous Thrombosis in Forearm veins-if any.


Remedy Suggested in the mean while-
Rest and Elevation of the Left Fore arm in Fore Arm Sling.
Elevation of the Left Forearm while Sleeping
Anti-inflammatory drugs/
Hydrolytic Enzymes-like Chymotrypsins/Serropeptidase for reducing edema in the forearm tissue
Phlebotropic drugs like Daflon-for reducing venous congestion

Mild Physiotherapy/Avoid any strainous Physiotherapy as it would be counterprodcutive

Awaiting for above information and any further query in this regard,for review and study in the next session.

Good Day!!

Dr.Savaskar, XXXXXXX Surgical Specialist
M.S.Genl-CVTS




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

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Mukund Savaskar

General Surgeon

Practicing since :1978

Answered : 3606 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
What Causes Forearm Swelling Post Forearm Injury?

Brief Answer: ? Left Forearm Compression Syndrome /Under Investigation Detailed Answer: Brief Ans-? Left Forearm Compression Syndrome /Under Investigation (as assessed from your updated photos) Hi,Welcome for your query to HCM. I studied the complex text of your query for the Forearm injury with compression of the forearm compartments with entrapment complaints of indefinite and complex nature which would multiple sessions to study your case. As such, Based on the understanding of your last query data, I would suggest you- a- to update a photograph of both of your forearms- exposed from your shoulders to tip of your hand fingers from a distance of 2-3 feet,where I would get to know the condition of both the forearms of your hand b-update photograph of the affected forearm only from 2-3 feet with exposure right from your shoulder till the tip of the hand with knuckles exposed. Besides this please give more details how the whole complaint scenario progressed from -at first 1 mth / 3mth/ 6 mth/ and at 9 mths and at 12 mths in brief if you can in short ,which would give me a chance to study your progress , and would help me to pinpoint areas ,which need to be stressed while advising a Primary plan of suggestions to begin with. Hope you understand the importance of updating above 2 -4 sets of photographs of your affected and of both the forearms including from Shoulder to tip of the hand fingers and knuckles exposures from Front and from the back side of both and individual full upper arms. Await your photos for the study and to review your case in next session. Good Day!! Dr.Savaskar, XXXXXXX Surgical Specialist M.S.Genl-CVTS