So you hurt yourself this weekend. Is this just a bruise, something that will go away on its own, or did you do something more serious; something that requires medical attention?
Obviously this very important question cannot be completely answered in a simple blog, but there are some general principles that will help you determine whether you need to seek further medical care for your injury. The first few things are pretty obvious.
Is there a deformity? Does your finger, your wrist, your whatever, look like it did before? If not, then you very well may have sustained a dislocation or fracture. If there is obvious deformity, then get yourself seen as soon as possible.
Can you walk on it? Broken ankles (fractures) almost always hurt too much to walk on, but many ankle sprains will allow you to bear weight. If you really can’t put your weight down with your ankle injury, get it checked out right away.
Is the joint stable? The bones in all of our joints are held together by ligaments. When you dislocate a joint (like your shoulder, your elbow, your finger, or your knee), you have, by definition, torn the ligaments that hold the joint together. If the joint remains dislocated, that needs immediate attention. A dislocated joint needs to be reduced right away (see deformity above, remember?). However, after a dislocated joint is reduced, it is important to find out if it is stable, i.e., is it likely to ‘pop out’ again? If a joint is not stable after it is reduced, that can often require surgical repair. It is definitely NOT okay that a joint continues to re-dislocate! Even if a joint doesn’t ‘pop out’, if it continues to feel unstable, like it wants to give out, that needs to be evaluated by an Orthopedic Surgeon.
Does it work? Have you lost function after your injury? One of the hallmarks of a rotator cuff tear, or tendon rupture in your shoulder, is the loss of the ability to lift your arm, or at least loss of strength. If motion and strength do not return within days, you definitely need to be evaluated.
Injuries that involve the nerves or blood vessels to a limb can be very serious. If you get a cut or wound, and there is immediate numbness afterwards, you may have cut a nerve. Identifying this injury, and repairing it promptly, will definitely lead to the best result. Similarly, if there appears to be decreased blood flow to an area (usually noticed as skin staying blanched or pale for a prolonged period of time), that could be a surgical emergency.
Finally, a word about swelling. Swelling is not uncommon after an acute injury, and is due to bleeding locally into the tissues. However, chronic swelling is most definitely NOT normal. Joints that repeatedly swell need to be evaluated.
Obviously most injuries do not need the skills of an Orthopedic Surgeon, and can be properly treated by you, at home. Check out my blog on Initial Treatment of Your Injury, if you want to learn that RICE is a whole lot more than a grain!
Written By: Dr. Noah Weiss M.D.