Warning signs — when to call

What is normal

Pain that decreases gradually over a few days, swollen fingers, bruising that tracks down toward the wrist or up the forearm, a small bloodstain on the dressing on the first day, morning stiffness, and a tender scar for several weeks.

All of that is part of healing and does not need a call.

• Bruises turn green then yellow as they resolve: that is normal.
• Fingers swell more at the end of the day and when the hand hangs down.
• Throbbing during the first few nights is common.

Call the office

Some signs are not immediate emergencies but need to be assessed the same day. Contact the office or the nurse clinician.

• A temperature of 38 °C (100.4 °F) or higher.
• Redness spreading around the wound, or thick, foul-smelling discharge.
• Pain that increases after 48 hours instead of settling.
• A soaked dressing, or a cast that is cracked, wet or has become loose.
• A wound that opens, or a stitch that gives way.

Go to the emergency department without waiting

The following can indicate compression of the tissues or a problem with the circulation. They do not improve with time and need immediate assessment — do not wait for a call back.

• Fingers that are cold, white or bluish, or that lose sensation.
• Severe and increasing pain that does not respond to the prescribed painkillers.
• Very sharp pain when the fingers are gently straightened by someone else.
• A dressing or cast so tight that the fingers are suffering.
• Heavy bleeding that does not stop after ten minutes of pressure with the hand raised.
• Shortness of breath or chest pain — call 911.