Bone injury

A bone injury is called a concussion periostitis, as a rule, this trauma is a consequence of a blow on the straight axis into the bone, and, therefore, in the periosteum, which is located quite close under the skin. Most often the periosteum of the elbow joint, knee, cranial bone, joints and hip bones suffer. A bone injury is accompanied by a subarachnoid hematoma, then a periostitis develops, which is visible on an X-ray.

[1], [2], [3], [4], [5],

Bone injury, types of periostitis

Periostitis is the inflammatory process of the periosteum, which can be caused by various causes. However, the most common cause is bone contusion. Inflammation develops in the internal layers of the periosteum, then spreading throughout the tissue. Since the perioste is connected to the bone tissue, the inflammation also passes to the bone tissue, osteoperostitis develops. In traumatological clinical practice, bone contusion occurs quite often, and periostitis is divided into an acute and chronic form of the inflammatory process. In addition, traumatic periostitis has different types, depending on the severity of the injury, the state of the bone system and the overall health of the affected person. So, in diabetics, the bruise of the bone is fraught with purulent periostitis, in elderly people ossifying inflammation can develop. There are also serous, tubercular, fibrous and simple periostitis. 

Periostitis is simple, usually occurs in an acute form, which is accompanied by swelling, redness of the skin in the zone of concussion. The place of a bruise at palpation is palpated as thickened, tuberous, there is an infiltration. A simple periostitis is a typical complication that is fraught with a bone injury. As a rule, other causes of it are less frequent, among them one can call the proximity of inflammatory foci in muscle or bone tissue, not connected with concussion. Symptomatically simple periostitis is manifested by severe pain, localized edema. Often, the inflammation passes by itself, this happens with the active functioning of the immune system and provided that the bone injury was weak. However, this complication can trigger the growth of fibrous tissue, the formation of osteophytes (neoplasms in bone tissue), which is characteristic of the ossifying species of periostitis. 

Periostitis, accompanied by the formation of growths, is called ossifying. This is due to the intense multiplication of cells of the inner periosteal layers. On the growths begin to grow new, atypical formations in the form of calcium salts, fibrous tissue. The nearby bones begin to fuse with the damaged bone, which leads to disruption, and sometimes even to a strong limitation of motor activity. 

Periostitis, which is called fibrous, is formed as the disease is hidden, imperceptibly. This is a chronic, sluggish inflammatory process with periods of fading and relapses. Sometimes fibrous periostitis develops for many years as a result of constant irritation of the injured periosteum. Gradually, a peculiar callus, fibrous tissue begins to grow on the mettexis of damage. The cause of fibrous formation can not always be a bruise of the bone, but a concussion, not diagnosed in time and not supervised by medication, is quite capable of leading to chronic periostitis. 

Purulent periostitis is rare in clinical practice, but later a doctor's appointment and neglect of the disease, to which the bruise of the bone has led, may give impetus to the purulent inflammatory process. Symptoms of such a periostitis are specific: fever, sometimes up to 38-39 degrees, severe pain in the place of injury, acute pain during palpation of the affected area, swelling of the limb or body area, general deterioration in health. Sweating and fluctuations may not be, for purulent periostitis this is not typical, but rather hard upon palpation, swelling is a typical sign of purulent inflammation of the periosteum. Complication can be an abscess that rapidly progresses and spreads to the bone tissue.

[6], [7], [8]

Bone Injury: Treatment

The standard algorithm for bruising remains relevant for bone contusion. As the first action, it is necessary to ensure complete rest and immobilization of the affected area of the body. If the bruise of the bone has fallen on the leg, the victim assumes a horizontal position, and the leg is slightly raised and placed on the platen (pillow). A cold compress is applied to the injured zone, it can be a hot-water bottle or ice container, a bottle with very cold water. Cold apply on a dry cloth, covering the area of the injury, to prevent the excessive effect of cold on the skin. Cold packs should be periodically changed, as they warm up. If the skin is damaged (wounds, scratches), before applying a cold compress, the wound should be treated with an antiseptic. Then cold and top pulling bandage, fixing the limb. With a strong pain symptom, the victim is given an anesthetic drug (ketoral, ibuprofen, analgin). As a rule, the pain caused by the bruise of the bone is very intense and lasts for several days, so the intake of anesthetics is acceptable within two to three days. Hospitalization is indicated in case of pain shock, severe swelling and obvious signs of sprain, dislocation, fracture or bone fracture. The bone contusion, which provokes a purulent periostitis, is also treated mainly outpatiently with the help of antibacterial therapy, anti-inflammatory non-steroid drugs. The exception is cases of acute purulent infection, which are accompanied by the threat of general intoxication and sepsis.

A bruised bone, for all its prevalence and apparent routine, is a trauma that affects a very vulnerable bone tissue - the periosteum. Therefore, if the concussion of bone tissue is manifested by severe pain, symptomatic dynamics showing deterioration of the condition, it is necessary to consult a doctor - traumatologist, surgeon.

[9], [10], [11], [12]