A simple closed phalangeal fracture with fragment displacement is a rare phenomenon in practical traumatology. They occur with severe trauma, accompanied by bruising and crushing of the ligaments and muscles on the legs. Much more often with a fracture of the fingers, two sections of the broken bone go past each other. The similar nature of the fracture can be explained by the fact that the soft tissues of the foot have a high degree of elasticity, fragments move and pull during trauma. Visual shortening of the damaged finger occurs, in the future it grows together incorrectly.
In children, closed with angular displacement is much more often observed. The periosteum, bone tissue in children is much softer and more elastic, often childhood injury is not recognized and is regarded as a bruise. As a result, the finger does not grow together correctly and remains deformed. Often the direction of the traumatic factor is along the axis of the toe, and the fracture is difficult to distinguish from a bruised foot.
The joint takes the main load, soft tissue bruising, cartilage deformation and a number of cracks in the joint area occur. A closed fracture is difficult to distinguish from damage without displacement. However, with a thorough examination, X-ray examination, there are differences. In some cases, it is possible to detect an overgrown fracture of the toes retrospectively in the pictures.
How to detect damage without displacement
Violations of the integrity of bone tissue without displacement of bone fragments are classified in a similar way:
- In the direction of the traumatic effect - transverse and longitudinal.
- By the nature of the fracture line - oblique, helical and so on.
- By the mechanism of the traumatic factor - direct and indirect.
With the direct nature of the injury, the only fracture line is distinguished, visible in the picture only where force is applied. The formation of secondary fractures is often seen, which are obtained at a distance from the place of direct impact and are formed under the influence of muscle traction. Mostly, such foot injuries are paired and often fuse incorrectly.
According to the number of fragments of the bones of the toes of the foot, the lesions are shatterproof, single or multi-fragmented. The first type of violation of the integrity of the bone occurs with a direct fall on the leg. If a dull and smooth heavy object acts on the toes, it causes soft tissue bruising and the formation of one or two bone fragments. If the blow is received with an uneven object, a multi-fragmented injury of the toes is obtained, often wearing a closed character.
Symptoms of bone integrity disorders
Determining the nature of the damage, the ICD code 10 and the main clinical signs is the primary task in providing assistance. Questions are included in mandatory programs of specialized medical education. Timely recognition of fracture symptoms will allow the physician to establish the correct diagnosis and ICD 10 code, and provide emergency assistance correctly. This directly depends on how much bone is fused after damage.
Symptoms of damage to the bone of the toe show similarities with signs of damage on other parts of the body. Signs are divided into probable and reliable.
Possible symptoms include:
- The appearance of sharp pain at the site of damage.
- Hyperemia of the skin and rapidly increasing edema. With severe edema, not a continuous plaster cast, but a lateral brace.
- The position of the finger becomes forced.
- The temperature of the soft tissues at the site of destruction rises.
- Free movements in the joint are significantly hindered or completely absent.
- If you tap on the tip of your finger, sharp sharp pain develops.
With a toe injury, the pain is always bearable. This allows you to distinguish it from damage in the other part of the leg. When the pain syndrome is so pronounced that it causes loss of consciousness in the victim. Damage to the toes practically does not lead to such violations. The pain in these cases is due to two pathogenetic mechanisms: directly in the acute period after striking or falling on the toes, the periosteum hurts, which is characterized by a high degree of innervation. Gradually, a dull, aching or bursting pain begins to develop at the site of the lesion. Its origin is associated with an increase in swelling of injured tissues due to impaired blood flow and signs of an inflammatory process.
If soft tissue bruising, periosteum rupture, and bone integrity are impaired, in response to pain and spasm of the vessels, inflammatory mediators — serotonin, bradykinins, are released into the blood, causing the development of clinical signs of inflammation. Biologically active substances cause atony of small vessels at the site of damage, provoke fluid effusion from the vascular bed into the intercellular space of the soft tissues of the leg.
If you gently tap the top of a broken finger in the direction of the axis, the action will respond with a sharp pain at the site of damage. The symptom is fundamental to the recognition of fractures. The correct diagnostic procedure will allow you to accurately get ahead of whether a soft tissue injury has been received or the bones have suffered. The fracture is characterized by pain exclusively at the site of violation of the integrity of the bone tissue. A bruise with such striking does not manifest itself.
However, when carrying out the described diagnostics, it is important to remember: if displacement of fragments or an injured type of injury is suspected, the procedure is strictly prohibited, it can worsen the condition and increase the displacement of fragments.
Signs that reliably indicate the presence of bone damage that are not similar to other injuries include:
- On palpation, the presence of a broken bone fragment is detected.
- A broken finger is shortened.
- There is bone mobility in uncharacteristic places.
- Visually, the bone is deformed.
- On palpation, it is possible to determine the crepitation of the fragments.
Feeling the damaged areas of the foot should be extremely careful. It is required to carefully guide with your fingers along the damaged bone, pressing lightly to understand how many fragments there are. This is done in turn on the surfaces accessible to feeling. It is easier to conduct research in areas where the bone is not deep and is easily accessible for examination and palpation.
If the finger is positioned incorrectly and shortened compared to the symmetrical one on a healthy leg, most often this becomes evidence of the longitudinal penetration of the broken fragments.
The pathological mobility of the fragments is determined simultaneously with the presence of friction and deformation of the bone axis. At first, it is supposed to conduct a visual assessment of the injured leg and compare it with a healthy one. Then the distal fragment is carefully taken, the proximal is fixedly fixed. If during the attempt to deflect the distal fragment from the normal physiological axis, the action can be done, we can talk about the existing pathological mobility. When checking, a crunch is determined by ear.
It is not always advisable to conduct a study to detect reliable signs, the procedures cause severe pain to the victim. Symptoms can be identified by visual inspection or the patient's unfocused movement.
Types of Leg Fractures
Limb injuries come in many forms. Depending on this, a specific treatment is suitable for each individual case. There are such types of them:
Clear diagnosis is easy. This is possible for a person who does not have a medical education. An open wound and the presence of fragments in it indicate this.
Fracture with displacement is also an easy diagnosis to diagnose; with it, a deformed bone is clearly visible at the site of the lesion.
During the determination of the type of damage it is impossible to make unnecessary movements. When probing damage with fragments, this must be done with extreme caution. You can not make any movement to displace bone fragments.
Fracture is one of the most difficult injuries, and its treatment requires a responsible approach. A fractured leg among all such ...
The hardest thing to diagnose is the closed type of injury. You can understand this using two methods:
- For this, axial load syndrome is used, consisting in not strong pressure on the injured leg.
- With the help of a light tapping on the foot, the place of damage is determined, it gives away severe pain.
The final diagnosis is made only after an x-ray.
It is very difficult to determine the type and nature of a knee injury due to its complex structure. Prior to making an accurate diagnosis, in order to avoid injury complications, it is necessary to provide the patient with the full property of the injured leg.
Signs of a fracture
An injury accompanied by a violation of the integrity of the bone or periosteum is considered a fracture. Regardless of its nature and type, the following symptoms are observed:
- Severe pain during an injury that does not decrease after a few hours. Sometimes the pain, on the contrary, increases.
- At an accelerated pace, an increase in edema is observed, which is accompanied by severe bruising. Swelling is formed after 2-3 days after what happened. There are some types of damage when the swelling is not fixed at all.
- Trying to stand on a damaged leg or take something with an injured hand leads to severe pain. With a broken rib, it is very difficult for the patient to inhale or turn the torso.
- The displacement of bone fragments is easily determined. There is deformation and shortening of the injured limb. Or, on the contrary, it becomes longer healthy. A crunch is heard during trauma and when feeling. For damage with displacement, pathological mobility of the limb is characteristic.
- With an open fracture of the extremities, a bleeding wound is visible, from which broken bones are visible.
- When tapping the heel, if a leg fracture is suspected, severe, sharp and sometimes unbearable pain is felt at the site of injury.
Injuries of the lower extremities quite often entail the appearance of severe edema. After removing the cast, such a reaction ...
When injured, soft tissues are injured, but they remain intact. The following symptoms are characteristic of this injury:
- The pain that appeared immediately after the bruise gradually subsides over time.
- Swelling is increasing. When lifting a bruised limb slightly up, swelling becomes smaller.
- and pain does not allow the free movement of the nearby joints.
Such symptoms can accompany fractures, especially if there is no displacement. Only a specialist can correctly distinguish a fracture from a bruise. At the same time, modern diagnostic methods come to the rescue - radiography and computed tomography. No need to joke with such damage. It is better not to self-medicate and immediately seek medical help.
How to distinguish a fracture from a bruise
Typically, qualified doctors will deal with this issue. But sometimes there are times when there is no way to get to the hospital, and for first aid it is necessary to understand the nature of the injury.
An open fracture does not cause difficulties in diagnosis. It is much more difficult to have a closed fracture, especially with minimally pronounced symptoms.
It is worth noting the following signs, with which you can determine a fracture or injury in a person:
- With a bruise, pain is felt, but it is tolerant and gradually subsides. Fracture is accompanied in many cases by intense pain, which only worsens over time.
- Of the external manifestations with bruising, slight swelling and the presence of a small hematoma are noted. Fracture is most often accompanied by severe swelling, bone deformity and a clearly visible hematoma.
- During palpation with bruise, the pain intensifies, with a fracture, the sound of a crunch is added to this symptom.
- A bruise does not limit a limb in movement. When a fracture is given more difficult. If motor activity, for example, of the fingers of a broken leg, does not disappear, then it is impossible to raise it, this causes incredible pain.
- A bruise does not affect general well-being. In a fracture, a person may feel satisfactory, or may experience severe pain shock, from which only analgesics can save.
Which doctor to contact
In case of a bruise or fracture, a specialist consultation is necessary. To do this, seek help in traumatology or surgery. An orthopedist-traumatologist is involved in the treatment, but the surgeon can also cope with the task.
The upper limbs are prone to trauma. One of the most typical injuries is a bruised arm in the area between the elbow joint and the wrist. Anatomically, this area is called the forearm. Despite the apparent simplicity of the injury and the ease of the injury, a painful condition can limit the quality of life for a few weeks. Moreover, the consequences of some injuries can persist for a long period, leading to serious impaired limb function.
Shulepin Ivan Vladimirovich, traumatologist-orthopedist, highest qualification category
Total work experience over 25 years. In 1994, he graduated from the Moscow Institute of Medical and Social Rehabilitation, in 1997 completed a residency program in the field of traumatology and orthopedics at the Central Research Institute of Traumatology and Orthopedics named after N.N. Prifova.
A painful condition is a traumatic injury to all tissues of the forearm without destroying the bone structures. Muscles, subcutaneous tissue, and also vessels and nerves located in this area usually suffer. The main cause of hand injuries is trauma due to direct strong contact of this part of the body with a hard surface.
The most common problem occurs in the following situations:
- when falling on hand
- with a knuckle injury during sparring athletes or in a street fight,
- when hitting a hard surface,
- during careless handling of equipment in a summer residence,
- as a result of compression by two solid objects.
Since hands are an integral part of an active person’s life, they are often traumatized in the process of domestic or sports activities. Hand injuries occur regularly in the following populations:
- gardeners and gardeners,
- locksmiths and joiners,
- elderly people,
The mechanism of injury is always the same - as a result of strong contact with a hard surface, soft tissues of the forearm are damaged. This leads to the rupture of small capillaries, the destruction of nerve fibers, as well as muscle damage. As a result of a violation of the integrity of the vascular wall, local hematomas form, and in the area of the injury, edema is formed and increases.
The main manifestations of bruises
The problem is always the result of acute injury, so all symptoms develop immediately after it is received, and then progress. The forearm is anatomically characterized by a small layer of subcutaneous fat, so with bruises, the probability of damage to nerve trunks and vascular trunks is high. In the same area there are bone structures of the wrist joint and small joints of the hand.
The clinical manifestations of the bruise are as follows:
- severe pain in the area of damage that radiates to the shoulder, hand or even to the axillary region,
- swelling of the tissues of the forearm,
- flushing of the skin, which then turns into a long-lasting cyanosis,
- impaired limb function,
- the inability to work with a brush,
- numbness and paresthesia of the distal upper limb.
A bruise can capture the bones of the wrist, elbow, and also adjacent parts of the limb - the shoulder or phalanx of the fingers. In this case, there is a sharp restriction of the function of the hand, it is numb, since the painful condition is accompanied by damage to the nerve structures over a large area.
The main symptom that causes the patient to seek medical help is pain. Its strength was initially determined directly by a strong blow, and then persists due to the formation of a hematoma.
Any damage to the radial bone enhances pain, but there are no visible fractures with bruises. A swelling of the hand due to massive edema caused by impaired blood circulation and lymphatic drainage remains for several days.
As the function of the hand is restored, the pain disappears at first, and then swelling, and only then does normal skin color appear. However, bruises can persist for a very long time, since their resorption greatly depends on the individual characteristics of the blood parameters and the strength of the traumatic effect.
There are three degrees of severity of a bruised arm. Below are their main differences.
- Slight bruise. Injury is limited to a small area. Bone structures and great vessels are not damaged. All clinical manifestations disappear within 2 weeks.
- Bruising of moderate severity. Pronounced swelling and pain. There is a hematoma, which is characterized by a persistent course. Отдельные участки размозжения мягких тканей. Костные структуры интактны. Реконвалесценция наступает в течение месяца.
- Тяжелый ушиб . Признаки размозжения мягких тканей и повреждения надкостничных структур. Резкие боли, длительный отек, поражения нервных стволов и магистральных сосудов. Often there are complications requiring surgical treatment. Reconvalescence is long, symptoms of general intoxication last up to a week, and recovery takes up to 3 months.
A serious bruise cannot be quickly cured, since often neurological disturbances (a hand goes numb) subsequently persist for a long time and limb function decreases.
A long-lasting hematoma has a high risk of infection, which is dangerous for the development of phlegmonous inflammation. As a result, ossification sometimes occurs, which makes the muscles hard, poorly functional and requires surgery.
One of the varieties of the pathology of the distal parts of the arm is a fist bruise. It arises as a result of direct contact of a limb in a compressed state with a solid object. As a result, a sharply painful seal forms on the back of the palm of the hand below the wrist joint. This bump after a strike lasts a long time, as it is a consequence of crushing of soft tissues and local edema that has arisen. As a result, ossificates are formed at this place, which are removed surgically.
How to distinguish manifestations of a bruised arm from a fracture
The first question that a person who is injured is the exclusion of a fracture. The table below discusses the main distinguishing features of these pathological processes.
|Symptom / nature of injury||Bruised arm||Fracture|
|Pain||Moderate, aggravated by movements||Very strong, almost unbearable, possible traumatic shock|
|Appearance of the limb||Normal, no change in shape observed||Clear deformation of the arm in the fracture zone, unnatural limb position|
|Hand function||Saved but reduced due to pain||Limb movements impossible|
|Bone fragments||Outwardly not visible||Clearly defined by palpation and visually|
|Roentgenography||No changes detected||Fragments of bone fragments are clearly visible.|
It is often impossible to determine exactly if there is a fracture based on only clinical data. Due to the individual sensitivity of the body, pain can be very difficult to tolerate, and tissue compaction after contusion can mimic a fracture. Therefore, it is imperative to contact the emergency room as soon as possible for a complete diagnosis of the problem.
Diagnosis of hand injuries
In most cases, a bruise is not life threatening. However, in the diagnostic process, it is important to distinguish it from other serious injuries - fractures, sprains, or ruptures of muscles and tendons. Therefore, in addition to clinical examination and studying the details of damage, instrumental examination is indicated. Below are the main stages of the diagnostic search.
- X-ray of the forearm. It helps the doctor to understand whether there is a bruise or fracture of the limb, since bone structures are clearly visible during the examination.
- Ultrasound The method provides diagnostics of the state of soft tissues - the presence of hematomas, muscle breaks or tendons.
- CT scan . If x-ray questions remain regarding problems with bone structures, then you should study them in layers. This is ensured by CT of the forearm.
- MRI This exact method is rarely used, but it is indispensable in the diagnosis of processes occurring in soft tissues. MRI helps to understand whether there is a bruise or muscle strain, small tendon ruptures and hidden hematomas.
Additionally, blood tests are used to assess the level of hemoglobin and acute phase indicators. The entire diagnostic search is carried out in a short time, as it is necessary to assess the severity of the injury.
Emergency care general principles for the treatment of bruised hands
Since the reaction of the body to the resulting trauma develops especially rapidly in minutes, it is necessary to quickly provide qualified first aid. It includes the following points:
- free your hand from clothes
- apply cold - if it’s ice, then not on the skin, but through a towel or bandage,
- to provide immobilization, since it is very problematic to visually distinguish signs of injury from a fracture,
- give an anesthetic - the diagnosis in a medical institution is not based on the subjective sensations of the patient, so taking analgesics is justified,
- transport to a hospital for examination by a doctor and radiography.
To ensure cold, it is better to use compresses with water, periodically changing the bandage.
Traditional treatment for hand injury at home
Usually a bruised hand requires treatment at home, since only patients are hospitalized with suspected serious injury or if it is impossible to exclude damage to the great vessels. General treatment guidelines include:
- taking analgesics, most often from the NSAID group (diclofenac, naproxen, nimesulide),
- elastic bandage to improve hematoma resorption,
- external therapy to remove the tumor - anticoagulants and reparants (heparin, dexpanthenol),
- in the presence of damage to the nervous system - vitamins and antispastic agents,
- in the presence of a pronounced emotional reaction of the patient - sedatives.
If the hand is swollen in the child and hurts, then it is necessary to restore its activity in the shortest possible time. Compresses with cold saline, external gels for resorption of hematomas and analgesics from the paracetamol group will help. If they are not too effective, only ibuprofen can be used from non-steroidal anti-inflammatory drugs.
The principles of the treatment of bruised hands in the fall or after a strong blow practically do not differ. The most important condition for a speedy recovery is the use of cold in the first minutes after an injury. This will limit the size of the hematoma, which will quickly cure and restore the activity of the upper limb.
Recovery after a bruised arm and possible consequences
The problem does not apply to severe injuries, so convalescence occurs within 10-14 days. The bruises dissolve, during rehabilitation they become yellowish, and then only a hyperpigmented area on the skin remains.
However, as a result of a bruise, long-term consequences may persist. These include:
- suppuration of a hematoma,
- compression of the median structures of the hand, which leads to impaired blood circulation and innervation of the limb,
- ossification of muscles - a painful compaction in soft tissues that impedes active movements,
- damage to nerves and blood vessels.
The consequences of a bruised hand more often occur after a fall, since the mechanism of injury is associated with the effect of body weight on the upper limb. All complications are treatable, but rehabilitation sometimes increases to 6 months. The treatment process includes drugs that increase blood flow to the limbs, as well as improve trophic nerve tissue (peripheral vasodilators, muscle relaxants and vitamins). Sometimes surgical treatment is necessary to eliminate ossified sites.
Thus, a bruised arm is a painful injury that can permanently deprive a person of work capacity. The consequences of damage to the forearm can remain for many years, disrupting the function of the limb. Muscle ossification is especially dangerous, leading to the appearance of gross painful seals at the site of injury. In the absence of complications, a bruised arm disappears within 2 weeks, and severe cases last up to 3 months. The sooner the patient is provided with qualified care, the faster the favorable outcome of the injury. In most cases, conservative treatment gives a positive result and provides a good prognosis for a speedy recovery.
If the pain in the hand does not go away - the advice of a doctor
No one is safe from physical damage. If such a situation has occurred and the injury due to subjective sensations is serious enough, you should immediately consult a doctor. However, some time will pass before meeting the doctor, and first aid is needed right away. To act appropriately to the situation, you need to understand the difference between a bruise and a bone fracture.
Differences between a fracture and a bruise
A bruise is an internal tissue trauma, in which there is no violation of the integrity of the bones and skin. Bruises occur as a result of falls or other mechanical stresses on the damaged area.
As a result of a bruise, tissues and organs located in the affected area are damaged. In the case of severe bruising, swelling and bruising occur around the damaged area, and the lower limb itself loses its normal mobility.
With a fracture, a complete or partial violation of the integrity of the bone occurs. In this case, the injury also affects neighboring tissues, including muscles, skin, vessels and nerve endings.
Fractures occur for the following reasons:
- the impact of a sufficiently powerful external force, which is enough to destroy the bone,
- the effect of a small force against a background of a disease that weakens the structure of bone tissue.
Violations of the integrity of the bones are closed (most often) and open. With an open fracture, trauma to the skin and bleeding occurs. Broken bone is usually visible on the surface of the limb. With an open fracture, in addition to bone destruction, rupture of the skin and ligaments occurs.
If the violation of the integrity of the bone is closed, then the skin remains intact, and external signs of bleeding are not detected. However, hematoma from internal bleeding is possible.
Note! Hematoma is one of the symptoms of a fracture. However, if it is a hip fracture, a hematoma can appear on the second or even third day, since the femur is surrounded by a significant muscle and fat layer.
Fracture and bruising have many similar symptoms. To distinguish two types of injury from each other, it is recommended to pay attention to the following symptoms:
- In violation of the integrity of the bone, the pain does not subside and may even increase with time. Moreover, the pain is present even in a state of complete rest, since bone fragments press on soft tissues. As a result of the pressure of the fragments, the musculature reflexively contracts, trying to return to its original position, but this cannot be achieved due to sharp pain. With a bruise, the pain syndrome is usually less pronounced and gradually decreases.
- In the event of a fracture, maximum swelling is observed on 2 - 3 days. With a bruise, edema appears almost immediately after an injury.
- If the bone is broken, the motor activity of the limb is blocked due to a powerful pain syndrome. The leg is almost impossible to straighten.
- If the fracture is accompanied by a displacement, then an obvious deformation is noticeable on the leg. In addition, in some cases, the length of the damaged limb changes in comparison with a healthy leg.
- When probing the injured area, the patient may feel a crunch from bone fragments.
In case of a fracture of a finger on the patient’s leg, unceasing pain follows. Toes and feet swell, and a hematoma appears under the skin. The finger cannot be bent. The same applies to the foot - pain and swelling limit the possibility of its mobility. Perhaps the deviation of the finger in an uncharacteristic direction. The finger can hang out, creating the feeling that it rests only on the skin.
Gradually, swelling increases, and the finger becomes visually shorter. If you feel the fracture site, you can find a protruding bone. Walking with a fracture of a finger is very painful, and pain is felt anywhere in the foot - even if you rely on the heel.
The symptoms of a metatarsal bone fracture are:
- pain when trying to walk and palpating the foot,
- foot deformity
- puffiness captures both sides of the foot and moves towards the ankle,
- painful sensations intensify not only when resting on the foot, but also when it is turned,
- severe deformity of the foot.
Violations of the integrity of the femur bone does not happen very often - in only about 6% of fractures. However, in older people, such injuries are the most common - about 40% of all injuries of this type.
In case of damage to the femoral neck, pain is felt in the groin and hip joint. In this case, although with the help of palpation it is possible to intensify the pain, a sharp attack does not provoke palpation.
With trochanteric hip fractures, soreness is much more pronounced, increasing with a change in foot position. The limb itself is turned outward. In case of bone displacement, a broken leg becomes visually shorter. A damaged leg cannot be lifted from the surface, even with maximum effort.
In violation of the integrity of the bone of the injected type, the pain syndrome manifests itself not so obvious. Very often, victims perceive injury as a bruise, because, despite some soreness, they may well walk.
Hip injuries are determined only by instrumental examination using x-rays and MRI.
Help with injuries
First of all, it should be understood that, despite the fact that the fracture and bruise differ in symptoms, an accurate diagnosis cannot be made without an x-ray.
- A cold object (ice or compress) is applied to the injured area.
- When skin damage takes anesthetics.
- Anti-inflammatory ointments help. These drugs relieve swelling, pain and swelling.
On average, the rehabilitation period after a bruise takes from 1 to 2 weeks. If the hematoma has not disappeared during the indicated period, there is cause for concern and you need to see a doctor. In some cases, surgery may even be necessary.
In the event of a fracture of the limb, one must proceed according to the following algorithm:
- Provide peace to the victim.
- Apply a cold compress or ice to the injured leg.
- If transportation to the hospital is carried out on their own, the patient is lying down. After that, the injured limb is tied to a healthy leg. The legs are connected in two places - above and below the fracture.
- If for any reason the patient cannot be transported
What research is being done
Often a finger injury is not recognized by visual inspection. Slight pain leads to the fact that the patient does not suspect a fracture, does not consult a doctor, as a result, a closed fracture does not grow together correctly.
For a reliable diagnosis, it is necessary to carry out an X-ray examination of the foot in several projections. Based on the image, the doctor will be able to determine the nature of the injury, understand how many fragments have turned out and suggest how long it will take to heal the damage.
Fracture or contusion of the fingers of the upper and lower extremities - common damage. Due to diagnostic errors, fractures are sometimes regarded as bruising or sprain. The result is the displacement of fragments, improper fusion of bones, impaired function of the arm or leg.
With limb injuries, timely and complete diagnosis is required to prescribe adequate therapy. It is important for patients to know the characteristic symptoms that help distinguish a fracture from a bruise.
Diagnosis of brush injuries
The proportion of hand injuries is about 25% of injuries, the risk of injury increases in the workplace and in some sports. The main diagnostic method is X-ray examination , which helps determine the specific pathology in the patient - a bruise, dislocation or fracture. In difficult cases it is used computer or Magnetic resonance imaging .
A traumatologist is involved in the diagnosis of injuries, and the patient himself can suspect pathology when characteristic symptoms appear.
The brush is represented by the wrist, metacarpus (its middle part) and phalanges of the fingers. The wrist and wrist are damaged when falling on outstretched arms. When these structures are bruised, the following symptoms :
- severe pain at the site of the impact,
- swelling of the brush
- skin damage (abrasions, bruises),
- violation of movements - flexion and extension.
Finger phalanges are often injured in children and athletes (basketball players, soccer players, hockey fans). Symptoms of a bruise of the phalanx of the finger include:
- pain at the point of application of force,
- swelling of the finger
- redness, blueness of the skin,
- abrasions, subcutaneous hemorrhages,
- difficult flexion-extension of the finger.
Note! With a bruise, pressure on the finger along the axis (from above on the pillow) does not cause a sharp increase in pain. Unpleasant symptoms are reduced after applying cold objects or ice, applying NSAID ointment. Bruising is characterized by positive dynamics within 2-4 days (reduction of edema and pain, restoration of the hand).
What is a bruise?
A bruise is called closed damage to tissues or organs as a result of mechanical stress. Depending on the location, volume and depth of the location of damaged tissues, impact forces, bruises can have different manifestations. For example, a well-known bruise is a hemorrhage due to damage to blood vessels. The remaining symptoms are also familiar to many.
How to identify a broken finger
Timely diagnosis of finger fractures is important, since the restoration of hand function depends on the proper fusion of bones. Damage occurs more often with direct trauma, when, due to contraction of the interosseous muscles, the fragments are displaced at an open angle to the back side.
Визуально перелом со смещением будет проявляться такими изменениями пальца:
- деформацией и укорочением
- выраженной припухлостью из-за отека,
- подкожными кровоизлияниями.
Обратите внимание that during a fracture, during palpation of the finger, a bone protrusion from the palm of the hand, mobility of the fragments and local pain are determined. Extension of the finger is difficult. The axial load is painful.
Confirmation of diagnosis
To find out the exact diagnosis, the patient is performed roentgenography . For a clear visualization of the fracture line and the displacement of fragments, images are required in three projections - anteroposterior, lateral, oblique.
In the case when the radiography is uninformative, the doctor uses computed or magnetic resonance imaging. If methods are unavailable, a repeated x-ray examination is prescribed after 7-10 days.
To detect a lunar bone fracture, a picture in two projections is enough.
IMPORTANT: With a bruise of the hand, there is a lack of changes in the radiograph.
Diagnosis of damage toes
In injuries of the lower extremities, protruding parts are most often damaged - the first and second fingers, since they are less protected from external influences. Mostly indirect injuries are diagnosed.
A fracture often remains undiagnosed, because its symptoms are similar to those with a bruised foot. Since the toes do not carry such a functional load as the hands, the patient may not go to the doctor in the hope of self-healing.
The leading role belongs to X-ray examination . But even with timely access to a doctor, diagnostic errors are possible. An objective examination (examination, palpation) sometimes remains unrecognized fractures of the sesamoid bones (structures of small size, located in the thickness of the tendons). Often, the correct diagnosis is made when bone marrow is found in the area of the lesion in the image.
REFERENCE: Additional diagnostic methods for foot injury - computed and magnetic resonance imaging.
Direct trauma of the toes without changing their position and violation of the structure is called a bruise . In this case, the changes are diagnosed:
- swelling of one or more fingers,
- limitation of movement due to swelling,
- abrasions, scratches on the foot,
- pain at the site of the impact.
As a result of the pain syndrome, lameness appears, the patient cannot wear the usual shoes. To prevent bone deformation and reduce rehabilitation time after a bruised toe, it is recommended to use.
Note! With a bruise, the range of motion of the finger is reduced, but its position is typical. When probing, the pathological displacement of fragments and crunch is not determined. Axial pressure does not cause severe pain. Swelling increases gradually and decreases within a few days.
How to recognize a fracture - symptoms
The characteristic signs of a toe fracture immediately after an injury include:
- severe edema, which growing fast ,
- discoloration of the skin - from redness to cyanosis,
- sharp pain during palpation in the fracture zone, pressure from above on the small pillow, passive flexion and extension of the line,
- the formation of a hematoma on the side or back surface.
Since fractures of the toes are often closed, bone fragments do not move. But if due to the pull of the extensor muscles this happens, the finger takes unnatural position. Fracture not diagnosed in time leads to the development of complications, which is manifested by infection of the damaged nail bed, necrosis of the skin.
IMPORTANT: In case of improper adhesion of fragments, the patient experiences constant pain, limps, transfers the body support to the heel.
The video provides information on the structure of the brush, symptoms and tactics of action for a fracture of the scaphoid (wrist).
Everyone at any time, under certain circumstances, may be injured, both an adult and a small child. And there is not much difference what he is doing at this moment - breaking sports records, walking along a slippery corridor or playing in the yard with friends. To get injured a lot is not necessary - even one unsuccessful movement can end in disrepair. Can:
- bounce or jump off a tall object
- slip on ice or on a damp floor
- tuck your foot involuntarily or hit a hard surface,
- Become a member of the accident.
Therefore, information about the correct actions for injuries must be known and told about this to children.
Serious consequences with complications can be hidden under any trauma accompanied by painful sensations, hematomas and mobility limitations.
How to distinguish a normal bruise from a more serious injury? You must already have this information when you have received the damage yourself or if you have become a witness to an accident for correct actions during first aid, on which further well-being and preservation of physical activity depend.
Bruise and its symptoms, first aid
What is a bruise so familiar to us from childhood - abrasions on the knees, bumps on the forehead, bruises and scratches on the skin?
This is a trauma, the consequences of which are damage to soft tissues with the probability of involvement in the process of internal organs with the preservation of all their necessary functions.
The main symptoms of bruising can be distinguished:
- Swelling of the tissue at the site of damage.
- Minor subcutaneous hemorrhage.
- Preservation of motor abilities.
There are exceptional especially severe cases when the bruise is accompanied by more serious symptoms.
If the pain is difficult to endure, then it is necessary to give a remedy that relieves it, and if bleeding occurs, it is necessary to stop it with a homemade tourniquet, dragging a limb just above the injured area.
It is strictly forbidden to massage the damaged area, since bone fractures can shift during a fracture, which, in turn, can cause internal damage to the circulatory, nervous, muscular, and ligamentous systems.
How to distinguish injuries
After the injury, any person hopes for a favorable course. But anything happens, so it’s important to distinguish complex injuries from ordinary minor bruises.
The answer to the question: “How to distinguish a fracture from a bruise?” Is actually not as complicated as it might seem. There are several main features that make this task easier:
- If a fracture occurs, then the pain increases with each passing hour. With a bruise, it eventually disappears completely.
- As a result of the fracture, swelling appears gradually, with a bruise - immediately.
- Torn wounds remain from the fracture, a bruise or bump from the bruise,
- If a fracture occurs, then the functional activity is significantly impaired. A bruise is not accompanied by such serious motor impairment.
- Fracture with displacement is accompanied by external deformation, which is not observed with a bruise.
To find out exactly what happened to the person as a result of an injury - a bruise or a fracture, you can conduct a small examination on your own. When injuring the lower or upper limbs, you need to ask the victim to lean slightly on it, while slightly pressing on the injured area along the bone. If acute pain occurs, it can be said with almost 100% certainty that a fracture has occurred.
The most accurate diagnosis, which will find out what kind of injury is a fracture or a bruise, will be made by a traumatologist after a full examination and an X-ray examination.
First aid for bruises and fractures, despite the difference in symptoms, must necessarily be done according to the classical scheme with small corrections for the complexity of the injury. It:
- immobilization of the victim,
- treatment of affected skin areas with alcohol-containing preparations,
- taking medications that can relieve pain,
- fixation of an injured limb.
The need for medical assistance
We live in an enlightened time and ourselves know a lot - we even undertake to distinguish where the injury is serious and where it is possible to deal with it at home.
But you do not always need to rely on your own knowledge, it is very important not to miss serious damage. Therefore, the victim must be taken to the hospital if:
- he fell from a height
- injured: head, chest, spinal column, abdominal cavity,
- pain and swelling increase
- a crunch was heard at the time of the injury,
- a bleeding wound formed at the site of the injury,
- the hematoma does not turn yellow, but acquires a dark red color,
- the skin on the surface is getting hot
- sensitivity disappears
- lost consciousness
- heart rhythm is disturbed
- shortness of breath appears
- there is a disappearance of motor functions,
- urination is delayed.
Summer is a time for children and holidays for adults, but it is also a time for injuries. Children run, ride a bicycle, skateboard, roller skate and often fall. Very often, neither children nor adults know how to determine a person’s fracture as a bruise or dislocation? Knowing the signs of a fracture, you can easily determine what happened to the person and how to proceed. But before that, it is worth recalling that fractures are open (one of the most dangerous along with a fracture of the spine), closed, with a displacement of the bone, hammered in when the bone breaks and enters into itself and compression, which happens when falling from a height.
To find out how to determine a broken arm, you need to look at the general signs of a fracture and thereby determine whether a person has a fracture or a bruise. If the fracture is open (there is heavy bleeding), then you can’t hesitate, you need to immediately provide professional help, since in this case it concerns life and death.
If you do not know how to determine a leg fracture, then if you see an unnaturally bent limb, then this is a pure fracture. In addition, do not forget about the unbearable pain that the victim experiences with a fracture. You try to take a step with your injured leg, and you cannot do it with a fracture. Moving a broken leg is also very difficult and painful.
I would like to add that you always know an open fracture: bleeding, a wound from which a bone is visible. A closed fracture is more difficult, but always seek the help of surgeons even if you are not sure whether you have a fracture or not, and provide first aid as if you had a fracture.
The very first thing you need to do in case of a fracture is to stop the bleeding by applying a tourniquet, if the fracture is open, anesthetize with spasmolytic tablets, immobilize the broken limb, give water, shelter, as it will be cold to the victim, soothe. And most importantly, immediately call an ambulance.
- Rest for the injured part of the body, its elevated position (raise the limb, lie on the opposite side, etc.)
- Pressure dressing
- On the first day - applying cold (for the prevention of hematomas). Ice bubbles should be removed periodically so as not to cause damage to blood vessels at low temperatures. It is best to immediately apply pressure bandage for 25-30 minutes, then every 2-3 hours, apply for 10-15 minutes.
- In case of severe pain, swelling, large hematomas, it is recommended to consult a doctor. Supervision of a specialist may be needed with bruises of the head, internal organs, and other dangerous locations.
- It is not necessary to rub the place of the bruise and warm it in the first two days (after 48 hours you can warm it)
- It is important to remember that first aid for fractures and bruises, dislocations and sprains is absolutely identical: rest, cold, anesthesia.
- Physiotherapy and novocaine blockade for pain relief may be prescribed at the medical institution.
- Surgical treatment for severe injuries: piercing the skin and pumping blood from large hematomas, cleansing the joint cavity of the fluid, the introduction of antibiotics.
What is stretching?
Damage caused by traction, and not accompanied by a violation of the integrity of the tissues, is called stretching. Tendons, ligaments and muscles suffer - that is, the elastic parts of the body. Tissues are usually damaged in the area of the joints.
Signs of a sprain:
- Pain at the site of injury (especially with movement following the mechanism of injury)
- Sometimes - a small hemorrhage (bruise, see)
- Restriction of function of the damaged part of the body
- Rest and elevation of the limb
- Cold to the site of injury (as with bruises)
- Locking bandage on the joint (elastic bandage)
- With severe pain, swelling and worsening condition - see a doctor. More serious injuries have similar symptoms - rupture of ligaments, for example, often requiring surgical treatment. In addition, it can be difficult to understand whether a sprain or fracture caused such a dynamic.
- It is not necessary to rub and warm the place of damage for the first 2 days.
- Pain relief if necessary
- Physiotherapy after the pain subsides
- Gentle treatment for damaged parts of the body
- Disability recovery usually occurs after 1-4 weeks
What is a dislocation?
Dislocation is a persistent separation of the surfaces of the joint, normally adjacent to each other. Usually occurs as a result of mechanical stress (more often in middle-aged men). If the articular surfaces are not completely disconnected, then this phenomenon is called subluxation. Its signs are similar to a complete dislocation.
Trying to cure a dislocation of the house with poultices, lotions, compresses is a very dangerous undertaking. The doctor will be able to correct a fresh dislocation (up to three days) much easier than a chronic one, so every minute after the injury is expensive. In any case, it is impossible to correct the dislocation independently, since it is possible to aggravate the situation by tearing the ligaments, muscles, and even breaking the bone. The only thing that can be done is to provide maximum peace to the injured person, apply cold and call an ambulance, or quickly get to the emergency room yourself.
How to distinguish fractures from bruises
The main task of a traumatologist or surgeon is to determine the type of injury received by the patient. Typically, diagnostic measures include a visual inspection of the site of damage and a radiograph. In the case when it is impossible to quickly get an appointment with a doctor, a method called axial load syndrome is useful. With it, you can find out what type of injury a person received.
If the bone is damaged, its outer shell, called the periosteum, also suffers. The bone itself does not contain pain receptors, but they are located in large numbers in the periosteum.
In order to determine the type of injury, it is necessary to create pressure on the injured limb in the longitudinal direction.
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