Bone contusion

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

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Bone contusion, types of periostitis

Periostitis is an inflammatory process of the periosteum, which can be caused by various reasons. However, the most common cause is bone contusion. Inflammation develops in the inner layers of the periosteum, then spreading throughout the tissue. Since the periosteum is connected to bone tissue, the inflammation also spreads to the bone tissue, and osteoperiostitis develops. In traumatological clinical practice, bone contusion is quite common, and periostitis is divided into acute and chronic forms of the inflammatory process. In addition, traumatic periostitis has different types, depending on the severity of the injury, the state of the skeletal system and the general health of the victim. Thus, in diabetics, bone contusion is fraught with purulent periostitis, while in the elderly, ossifying inflammation may develop. There is also serous, tuberculous, fibrous and simple periostitis.

Simple periostitis, as a rule, occurs in an acute form, which is accompanied by swelling, reddening of the skin in the area of the contusion. The site of the contusion is palpated as thickened, bumpy, there is infiltration. Simple periostitis is a typical complication that a bone contusion is fraught with. As a rule, other causes cause it less often, among them are the proximity of foci of inflammation in muscle or bone tissue, not associated with contusion. Symptomatically, simple periostitis is manifested by severe pain, localized swelling. Often, the inflammation goes away on its own, this happens with the active functioning of the immune system and provided that the bone contusion was weak. However, such a complication can provoke the proliferation of fibrous tissue, the formation of osteophytes (new growths in bone tissue), which is characteristic of the ossifying type of periostitis.

Periostitis accompanied by the formation of growths is called ossifying. This occurs due to the intensive proliferation of cells of the inner periosteal layers. New, atypical formations in the form of calcium salts and fibrous tissue begin to grow on the growths. Nearby bones begin to fuse with the damaged bone, which leads to a violation, and sometimes to a strong limitation of motor activity.

Periostitis, which is called fibrous, develops as a disease hidden, unnoticed. It is a chronic, sluggish inflammatory process with periods of attenuation and relapses. Sometimes fibrous periostitis develops over many years as a result of constant irritation of the injured periosteum. Gradually, a kind of callus, fibrous tissue, begins to grow at the site of the injury. The cause of fibrous formation may not always be a bone bruise, but a contusion that is not diagnosed in a timely manner and not treated with medications is quite capable of leading to chronic periostitis.

Purulent periostitis is quite rare in clinical practice, however, late consultation with a doctor and neglect of the disease, which resulted from a bone bruise, can give impetus to a purulent inflammatory process. Signs of such periostitis are specific: increased temperature, sometimes up to 38-39 degrees, severe pain at the site of the bruise, acute pain when palpating the affected area, swelling of the limb or body part, general deterioration of health. There may be no effusion or fluctuation, this is not typical for purulent periostitis, and a swelling that is quite hard when palpated is a typical sign of purulent inflammation of the periosteum. A complication may be an abscess, which quickly progresses and spreads to bone tissue.

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Bone Bruise: Treatment

The standard algorithm of actions for bruises remains relevant for bone bruises. The first step is to ensure complete rest and immobilization of the injured area of the body. If the bone bruise is on the leg, the victim takes a horizontal position, and the leg is slightly raised and placed on a bolster (pillow). A cold compress is applied to the injured area, this can be a heating pad or a container with ice, a bottle of very cold water. Cold is applied to a dry cloth, covering the injured area to prevent excessive exposure of the skin to cold. Cold compresses should be changed periodically 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 a tightening bandage on top, fixing the limb. If the pain symptom is severe, the victim is given a painkiller (ketoral, ibuprofen, analgin). As a rule, the pain caused by a bone bruise is very intense and lasts for several days, so taking anesthetic drugs is acceptable for two to three days. Hospitalization is indicated in case of pain shock, severe swelling and obvious signs of ligament sprain, dislocation, crack or bone fracture. Bone bruise, which provokes purulent periostitis, is also treated mainly on an outpatient basis with antibacterial therapy, anti-inflammatory nonsteroidal drugs. The exception is cases of acute purulent infection, which are accompanied by a threat of general intoxication and sepsis.

A bone contusion, despite its prevalence and seeming ordinariness, is an injury that affects very vulnerable bone tissue – the periosteum. Therefore, if a bone contusion is manifested by severe pain, symptomatic dynamics showing a deterioration in the condition, it is necessary to consult a doctor – a traumatologist, a surgeon.

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