Question: Hello Doctor. My husband was involved in a motorcycle accident Tuesday evening 3-24-2015. The majority of the impact appears to be on his right side. His current injuries are two broken bones in his left foot and a great deal of road burn, abrasions on his Right arm, hand and leg, and his left arm hand and leg, although the skin damage on the right side is worse than the left side. He previously had a broken sesamoid bone in the right foot about 2 months ago. This remained broken on follow up previously, and remains broken per xrays taken the day after the accident. My concern is swelling that is occurring in his feet. The right foot is more swollen than the left. He states that he feels tingling sometimes as if his foot were "asleep". The right foot feels a little warmer than the left, and painful when he steps on it. He has two small abrasions on that right foot and he did lose a toenail on one of the toes of the right foot as well. He is on antibiotics and we are keeping the wounds clean and using silvadine on them. I had a friend mention to be mindful of a blood clot, and I am now really concerned if this might be a possibility. I have elevated his foot and calf this evening and will see if this helps the swelling. I am sure the area did sustain trauma due to the impact and am not sure if what he is experiencing is expected tissue reaction or if we need to consider something more urgent happening. I don't want to be an alarmist if what we have happening might be a normal process by the body as a reaction to such a trauma, but I also do not want to ignore a problem by passing if off as something else. Thank you so much for your expert thoughts and guidance.

Thank you Dr. Zografakis for your prompt reply. So far the swelling is in the foot and ankle area. I measured both calf's this evening and both right and left measure the same. I will keep a watchful eye for any increased swelling to the calf's and will ask his physician about some antithrombotic prophylaxis. We are being mindful of use of extra salt, drinking plenty of fluid, and now trying elevating the feet to see if this will help bring some of the swelling down. Is there anything additional to do to help reduce this swelling, or anything additional to the above that you can think of for us to do or watch for. Thank you again for your help with our questions.

Thank you so very much Dr. Zografakis for the information you have given to us. We are very appreciative of your help to us. I understand that it is difficult to tell what may or may not be happening here. We appreciate your guidance on what to watch for and will continue to monitor the status of the swelling. When our physician is available again we will ask about the prophylaxis unless the situation worsens and we revisit the ER for further testing and evaluation.