PN complicated by broken blood vessel

Posted By  CCF NEUROSURGERY MD on August 14, 1997 at 11:14:36:

In Reply to: PN complicated by broken blood vessel posted by Beej on July 15, 1997 at 18:22:42:

: Hope I can get some info... my left foot is numb, sensitive, nerve-damaged ;and last week (8 days ago) a 6inch screwdriver accidentally was dropped and (my luck) the point of it landed on the top of my foot (about 2inches from the middle toe) and broke a blood vessel. It didn't even hurt, however, within secs, it was like someone blowing up ,a huge purple balloon! Thought it might bust... . Applied ice, elevated the foot  and hoped for recovery... BUt, within 4-5 days, it started shooting stabbing "lightening-like" flashes of pain thru' my foot, while turning all shades of blue and purple. Went to MD... gave me Tyl.#3 with codeine and Aleve.. the Tyl. made me throw up and nauseous... he told me it had injured an already-injured nerve (the pools of blood were aggravating the nerve) and it might take 2 more weeks to heal. My question is:  Is it normal for it NOW to be turning bright red and swelling up clear above my ankle?  the actual pain is minimal unless I have had my foot elevated and then put it down.. (guess the blood rushing down there annoys it) Just hope the swelling and deep red color is a normal process.  seems if I stay off of it, it doesn't swell as much.. (the MD never said anything about elevation or this latest development)..   my Neuro. is 21/2 hours away... think I need to see him?? Or is this the tail end of my healing?/ Thankyou for any assistance. .    

[CCF NEUROSURGERY MD]

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Dear Beej,
It sounds like you ruptured a vein when you dropped the screwdriver on your
foot last week.  The blood pooled locally in the subcutaneous tissues and
swelled a bit, causing a local hematoma.  
The numbness and tingling you are experiencing may be one of two things.  
First, the screwdriver may have damaged a small nerve in the foot simply by
banging into your foot.  Or, the hematoma from the vien rupture is
putting pressure on that nerve and causing you discomfort.  In either case
a conservative approach is appropriate.  
In the acute setting the leg should be elevated and pressure applied directly
to the area to stop the hematoma, or 'purple balloon', from getting larger.  
The area may be sensitive for a few weeks but generally will get better on its
own.  You may take medicine as needed for pain, though this will resolve.
The hematoma will be black and blue initially and will turn to various colors
of the rainbow as the hematoma resolves.  The foot swelling is from subcutaneous
tracking of the blood and will get better.  Leg elevation is appropriate here.  
In general you should get better with time.  If you experience persistence of
leg swelling or pain beyond a few weeks you should consider speaking with
your local physician.  Good luck.