Bruise: causes, symptoms, diagnosis, treatment

Contusion (contusio) - damage to soft tissues due to the short-term action of the traumatic agent, not accompanied by the formation of wounds.

[1], [2], [3], [4], [5], [6]

What causes a bruise?

The bruise arises mainly from direct violence. Its severity depends on the type, mass and speed of action of the injuring agent, the zone of damage, the elasticity of the tissues, the degree of their blood supply, the age of the patient and other factors.

What are the symptoms of a bruise?

Pathologically an abnormality is characterized by partial destruction of subcutaneous fatty tissue, small blood and lymphatic vessels, hemorrhage into soft tissues, up to the formation of hematomas.

A victim who received a bruise complains of pain in the place of injury; the intensity of pain is different: the more pronounced hematoma and edema, the stronger the pain syndrome due to compression of nerve endings and stretching of tissues.

How to recognize a bruise?

Anamnesis

In the history there is an indication of an injury.

[7], [8], [9]

Examination and physical examination

In the place of injury, where there is a bruise localized swelling due to hemorrhage and inflammatory edema. The size of the swelling is greater where there is more loose subcutaneous tissue. An example is the swelling of the face, the rear of the hand, the area of some joints. In the same places, hemorrhages are more pronounced. They are detected on the 2-3rd day in the form of blue spots (bruises), as the decay and absorption of blood elements, changing the color of the blue-purple, green, yellow.

Palpation of swelling, where there is a bruise is painful. In places where the tissues are denser, they are enveloped in aponeurotic cases (for example, the forearm), compression of the nerve endings with hemorrhage and edema causes particularly severe pain.

Violation of the functions is most obvious when the limbs are damaged.

When strikes are made on the tangent, in some cases there is a detachment of the skin from the underlying tissues (sometimes on a large extent), which modifies the picture of the injury. Under the skin a cavity is formed, filled with exudate, mixed with blood and lymph. Clinically determine the extensive fluctuating swelling.

Another special form is the bruise of the joint, in which hemorrhage occurs not only in the periarticular tissues, but also into the joint cavity, hemarthrosis. The joint is enlarged in volume, its contours are smoothed, the swelling indicates the presence of free fluid in the joint cavity. If there is a bruise of the knee joint, a balloting (springing vibration) of the patella is detected. He is found this way: if you grasp the knee with the palms of your hands, pushing at him with your thumbs at the same time, the patella is suspended in the liquid and is separated from the femur.

[10], [11], [12], [13]

How to treat a bruise?

Contusion: treatment with conservative methods

The bruise is treated by resting the damaged part of the body, prescribing the cold during the first day to prevent hemorrhages and edema, resorptive and restorative therapy in the future.

Immediately after the injury, a cold is applied to the bruise in the form of irrigation with chloroethyl or applying ice packs. Every 2-3 hours, the blisters are removed for 30 minutes to avoid cold vasodilation. Apply a pressure bandage, which in the medical institution, if necessary, is changed to a gypsum longite. From 2 or 3 days to the place where there is a bruise prescribed UHF, later (as the pain syndrome decreases), thermal procedures (ozocerite, baths, compressions, rubbing), electrophotophoresis with anesthetics, anti-inflammatory, antihistamine and resolving agents (procaine, antibiotics, diphenhydramine, heparin sodium), LFK without forced and violent movements. With a pronounced pain syndrome, procaine blockades are necessary, metamizole sodium is prescribed.

[14], [15]

Bruising: surgical treatment

If the bruise is accompanied by the formation of extensive bruises and cavities with skin detachment, it is punctured with a thick needle, the contents are removed, antibiotics are introduced into the procaine solution, and pressure bandages are applied.

Hemarthrosis is also eliminated by puncture of the joint, after it necessarily imposing gypsum immobilization. The bruise often ends with the development of contractures. In order to avoid their development, early functional treatment is used.

[16], [17]

Estimated period of incapacity for work

If a person has received a bruise, the terms of treatment and rehabilitation are determined individually. Most often they range from 3 days to 4 weeks.

[18], [19], [20]