Soft tissue contusions

Soft tissue contusions or contusio are closed injuries to tissues or internal organs that do not affect or damage the skin. As a rule, soft tissue contusions do not violate the anatomical integrity of the injury zone and are not accompanied by serious complications. All types of injuries that are complicated by inflammation and deformation have their own nosological definitions.

Bruises are treated by doctors specializing in traumatology, but each of us needs to have information about what a bruise is and what actions should be taken as first aid for an injury. This is due to the widespread occurrence of bruises, which occur literally every day both in everyday life and in the external environment. The algorithm for diagnosing and differentiating a bruise from a fracture, dislocation or sprain will help you quickly get your bearings and take the necessary measures.

First of all, soft tissue bruises should be separated from more serious injuries to the bone, blood, and other systems and organs. Soft tissues are primarily the skin, the underlying tissue, which may contain a lipid layer depending on the location on the body. In addition, soft tissues include connective tissues that bind and cover muscle tissue (fascia), muscles, ligaments, and tendons. All soft tissues are permeated with blood vessels and nerves, which are also damaged by bruises.

[ 1 ]

Soft tissue contusions - mechanism of injury

A bruise is a direct injury caused by a blow, fall, industrial or domestic injury, sports injury, etc. Accidents, both car and any other related to transport, as well as man-made disasters and natural cataclysms are not included in the list of the main causes of bruises, as they are high-energy in terms of the mechanism of injury. Direct injury, considered a bruise, provokes a violation of the integrity of the vessels of the subcutaneous tissue, collagen tissue and fat layer. As a result of injury, the tissue of the tissue separates from the connective fibers (fascia), if the bruise is severe, the fascia themselves are damaged, as well as the muscle tissue. The denser and more multi-structured the soft tissues, the higher their shock-absorbing ability to protect bone tissue, including the periosteum. If the soft tissues are insignificant in density and there are few of them, for example, in the fingers of the extremities, sternum, anterior part of the shin, the bone itself is often injured, a periosteal hematoma develops.

How do soft tissue bruises manifest themselves?

• Pain of varying intensity, depending on the density and structure of the soft tissue.
• Hemorrhage into the subcutaneous layer, the appearance of bruises (hematomas).
• Swelling.

Soft Tissue Bruises to Watch Out For

A contusion of the soft tissues of the head that requires medical attention. It is almost impossible to differentiate a contusion from a concussion on your own, in addition, craniocerebral injuries can manifest themselves with remote symptoms, so with any head injury it is better to undergo a neurological examination.

If soft tissue bruises are accompanied by crepitus, when exudate and air accumulate under the skin, and a characteristic "creaking" sound is heard during palpation, you need to call a doctor. These symptoms are considered especially serious in cases of injuries to the nose, cheekbones, knees, and chest.

Chest contusion is often accompanied by fractures or cracks in the ribs. You can palpate the damaged area yourself and, if there is crepitus, atypical mobility, severe swelling, you need to call an ambulance. Crepitus may indicate developing emphysema, as well as swelling and difficulty breathing.

Contusion of the abdominal area (belly). With a contusion, damage to internal organs is possible, so pale skin, a drop in pulse, nausea and tachycardia, severe pain are signals that emergency medical care is needed.

Spinal contusion. This injury is one of the most dangerous. To avoid the risk of complications, even if clinical manifestations of a spinal fracture are not detected, it is better to consult a doctor. An X-ray can rule out possible threatening injuries.

Soft tissue bruises, despite their seemingly commonplace nature, are trauma, which means that self-treatment is only possible if you are absolutely sure that the bruise is classified as a minor injury. In all other cases, professional medical assistance is needed.

First aid rules if soft tissue contusions are diagnosed

A cold compress in the form of a container with ice, ice water or a cloth soaked in cold water. If possible, the bruise should be treated with ethyl chloride ("freeze"). Cold helps reduce the intensity of imbibition (the soaking and penetration of subcutaneous tissues with blood. Cold compresses should be changed as they warm up, to avoid thermal effects on the injured area.

Immobilization – rest, so that the injured part of the body is motionless. If the bruise is on the chest, a horizontal position with the upper part of the body raised is indicated. If soft tissue bruises affect the lower limbs, a horizontal position is also possible, in which the leg is slightly raised to ensure blood flow (roller, pillow). If it is a head bruise, a horizontal position is mandatory, however, you should carefully monitor the manifestation of symptoms in the first hour to avoid the risk of serious complications.

Fixation to reduce swelling and immobility. Immobility is provided by bandaging (elastic material), applying a splint, bandaging the limb to a healthy part of the body.

If the pain is intense, you should take a painkiller (analgin, paracetamol, ketanov, ibuprofen). However, the intake should be limited to one or two tablets per day. If the symptoms indicate the development of complications, taking medications can distort the clinical picture, which helps to establish the correct diagnosis.

The second day after the injury should be devoted to procedures that help the process of hematoma resorption, reducing inflammation and swelling. This can be gentle rubbing with ointments containing heparin, diclofenac. Also shown is the intake of drugs that belong to the non-steroidal anti-inflammatory group - orthofen, ibuprofen, nimesil, nimid.

After three to four days, you can undergo physiotherapy procedures - electrophoresis, magnetic therapy.