Patient :"Sports injury" categorization is the closest category I could find to summarize this injury. A month ago my mother fell breaking both wrists. They were not set properly and have healed a bit misaligned. At the time she fell, she also hit her face very hard and the skin on her forehead, upper lip and around her nose was red for a couple of weeks. The skin that was red is still swollen and when she touches it, the sensation is different than elsewhere on her face. Also, the wrist that had the worst fracture is now swollen worse than when she broke it. What would cause this sort of swelling and what can be done about it? JFYI, surgery is out of the question. We are not in the US and due to a weak heart, she would not survive the way they do surgery here. (She is 76.)
Symptoms: Swelling of hand and places on face. The radius sustained multiple fractures. The scaphoid is also possibly broken, but we don't know for sure. The swelling, however, is now all over the hand. Originally, the swelling was just over the wrist. Although she fell on July 27, and has been in a cast since that time, she has more swelling than in the beginning. Also, where she bled under the skin on her face is still swollen, although there is no longer discoloration. The only medication she takes is thyroid and multivitamins.
Thanks for your query and an elucidate history about your Mother.
Read and understood the detailed history your have provided.
The possible reasons that can explain the problems she is facing at the moment are:
-Since your Mother is hypothyroid and under 200 microgram dose, it is possible that it may be insufficient at the moment as the injury and the trauma of all sorts increase the requirement of the thyroid hormone and usually missed. Please get the Free T3 and Free T4 and TSH done and if needed get an increased dose.
-Osteoporosis and osteoarthritis itself are the hindrance to good healing and can contribute to the problem she has. The body tries to compensate by way of over-deposition of the bone (callus) and the area under treatment appears swollen.
- Cardiac problem can contribute.
-Tight plaster can cause the swelling as you have explained.
-Dependent edema due to the position of the affected part below the heart level.
I would advise you to get the necessary consultation of the Specialist Doctors to get a clinical evaluation, examination and investigations to correct any of the defects and add treatment as per the findings.
Investigations for Hemoglobin (anemia), Serum proteins particularly albumin are necessary and if not satisfactory need to be supplemented. These are very important in proper healing.
Elevation of the affected limb above the heart level when in lying down position is also very very important in reducing the edema that you have explained.
There may not be necessity for any surgery as such if the healing is proper as seen on X-rays or MRI/CT.
I hope this answer helps your Mother to get the correct diagnosis, deficiencies that get corrected and getting a good healing and results.
Wishing Her the best recovery and great health.
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