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Hip Contusion – SimpleTherapy

What is a Hip Contusion?

Contusions are deep bruises to the muscle and a hip contusion is no different. The American Academy of Orthopedic Surgeons reports that contusions are second only to strains when it comes to the most common sports injuries. Some contusions are minor injuries and may cause a professional athlete to be temporarily removed from a game, but many will not need any more additional treatment that would be required for a bruise. However, severe contusions may be far more damaging and need medical intervention to properly heal.

What Are The Major Symptoms?

At the moment of injury, a patient will feel a sudden, sharp pain in the hip, followed by a deep ache as the bruise develops. The site of the contusion will be discolored,  swollen and painful to touch. More severe contusions may cause blood to pool around the side of the injury, resulting in a hard swelling or hematoma. If left unchecked, a very bad contusion can result in shock due to internal bleeding and might also involve other injuries, like fractures or dislocations. Hip contusions can create stiffness and pain in the joints, making it difficult to walk and move normally.

What Causes a Hip Contusion?

Contusions are caused by trauma,  so any hip contusion is caused by a severe blow to the hip. Contact sports are a frequent cause and hip contusions can be caused when a player falls hard on their hip or collides hip-first into another player. Outside of sports hip contusions can be caused by bad falls, car accidents, and other blunt-force trauma that doesn’t break the skin.

What Are The Treatment Options?

During diagnosis, a doctor may use an MRI  to determine the severity and extent of a contusion. The RICE formula is often recommended: rest (limiting movement will let the contusion heal and help control pain), ice (15 – 20 minutes every hour to reduce pain and swelling), compression  (such as with sports tape or bandaging), and elevation (above the level of the heart, and in a gentle stretch position). Many contusions will heal relatively quickly on their own. Massage is not recommended, but NSAIDs and painkillers may be prescribed. In the case of a large hematoma, a doctor may choose to drain the swelling to speed up the healing process.

Hip Pointer – Johns Hopkins All Children’s Hospital

    What Is a Hip Pointer?

    A hip pointer is pain and/or bruising over the top or front of the hip bone. Most hip pointers are caused by a direct blow to the soft tissue and bone in the hip area.

    What Are the Signs & Symptoms of a Hip Pointer?

    A hip pointer causes pain and tenderness over the front and top of the hip bone. The area also might look bruised. Some people have pain when moving the hip, which can range from mild to severe.

    What Causes a Hip Pointer?

    Hip pointers are caused by a hard hit to hip area, usually during an athletic activity. This can happen:

    • in contact sports like football, baseball, soccer, lacrosse, hockey, and field hockey
    • in noncontact sports from contact with equipment like the pole in pole vault or the ball in soccer
    • from landing on a hard surface (in volleyball, gymnastics, basketball, figure skating, dance, or skateboarding)
    • in a crash (during skiing, snowboarding, cycling, or inline skating)

    How Is a Hip Pointer Diagnosed?

    To diagnose a hip pointer, health care providers:

    • ask about physical activities and if there were any recent accidents
    • do an exam, paying special attention to the hip

    Sometimes doctors order an X-ray or MRI to check for a broken bone or other injury.

    How Is a Hip Pointer Treated?

    Teens with a hip pointer need to rest the area. They should avoid any activities that make the pain worse or could cause another hit to the area. This may mean taking a break from sports.

    Your health care provider also may recommend that you:

    • Use crutches to take weight off the hip.
    • Put ice or a cold pack on the hip every 1–2 hours for 15 minutes at a time. (Put a thin towel over the skin to protect it from the cold.)
    • Wrap an elastic bandage around the waist/hip area for support and comfort.
    • Raise the hips on a pillow when lying down to help with pain and swelling.
    • Go for physical therapy or do a home exercise program to help with stretching and strengthening of the area.
    • Take medicine for pain such as ibuprofen (Advil, Motrin, or store brand) or acetaminophen (Tylenol or store brand). Follow the directions that come with the medicine on how much to take and how often.

    When Can Someone With a Hip Pointer Go Back to Sports?

    Teens who get a hip pointer can return to sports when:

    • they have full range of motion in the hip
    • they’re no longer limping
    • they’re back to their full strength
    • the pain is improved

    Going back to sports too soon puts someone with a hip pointer at risk for another injury that could possibly be more serious. Your health care provider will let you know when it’s safe for you to go back to sports.

    What Else Should I Know?

    If things don’t improve, see your doctor, as it may be a sign that you have a different or more serious condition.

Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
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Chronic Pain from Hip Bone Bruises

Bruises happen to everyone. Bruising usually shows on the skin with dark purple markings. Small bruises are common for athletes or anytime a person accidentally trips, falls or runs into something. Some people tend to bruise more easily than others. Normal bruises are not too much of a concern. Whenever bruising is severe or reaches the bone, that is when patients may need to rest or seek treatment. The hip has surrounding muscles and bones that make up this joint. Particularly, the pelvic bone is a large part of the body that connects to the femur and the rest of the leg. Bruises to the hip may be more severe than a bruise on other bones. Hipbone bruises can lead to chronic pain symptoms that seem to last over time.

 

Hip Bone Contusions

Bone bruises, or bone contusions, are from an injury to the bone surface. Bone contusions do not cause breaks or fractures, but they can lead to chronic pain problems. With the hips, if a strong impact hits the hip bone, blood will begin to cover the pelvis and swell with pain. The swelling comes from the blood buildup around the hips. Severe hip bone bruising can last several months. Someone in a traumatic event may suffer from bone contusions due to a large fall or strong hit to the body. Even if the bone does not break, it is important to find professional help. Even though blood vessels breaking around the joints is common for bone bruises, patients do not want to experience blood clots and more chronic pain.

 

Practice Bone Health

Bone bruises should naturally heal with rest and elevation but always monitor a bone contusion injury. Numerous hip bruises can weaken the bone. Repetitive bone bruises may also be a sign of other problems. With hip osteoarthritis, cartilage begins to deteriorate so the bones rubbing together can cause bruising. Chronic pain conditions that cause intense levels of pain need attention. So, patients should care for all their bones that way they can prevent further injury. Weak hip bones can turn into osteoporosis or a total fracture. Hipbone bruises are painful, so try to prevent this injury while learning how to heal if it does happen.

Doctors usually recommend rest, ice and elevation to the initial injury. An anti-inflammatory medication may help with any swelling. Make sure you are getting enough calcium in your diet to strengthen the bones. Strong bones are less likely to bruise. Muscles can protect the bones as well. Build up muscles around the hips to prevent chronic hip bone bruising.

2021 ICD-10-CM Code S70.01XA – Contusion of right hip, initial encounter

  1. ICD-10-CM Index
  2. Chapter: S00–T98
  3. Section: S70-S79
  4. Block: S70
  5. S70.01XA – Contusion of right hip, initial encounter




Valid for Submission

S70.01XA is a billable diagnosis code used to specify a medical diagnosis of contusion of right hip, initial encounter. The code S70.01XA is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions.

The ICD-10-CM code S70.01XA might also be used to specify conditions or terms like contusion of hip, contusion of right hip region or hematoma of right hip region.

S70.01XA is an initial encounter code, includes a 7th character and should be used while the patient is receiving active treatment for a condition like contusion of right hip. According to ICD-10-CM Guidelines an “initial encounter” doesn’t necessarily means “initial visit”. The 7th character should be used when the patient is undergoing active treatment regardless if new or different providers saw the patient over the course of a treatment. The appropriate 7th character codes should also be used even if the patient delayed seeking treatment for a condition.

ICD-10: S70.01XA
Short Description: Contusion of right hip, initial encounter
Long Description: Contusion of right hip, initial encounter




  • Injury, poisoning and certain other consequences of external causes (S00–T98)


    • Injuries to the hip and thigh (S70-S79)


      • Superficial injury of hip and thigh (S70)

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

  • Contusion of hip
  • Contusion of right hip region
  • Hematoma of right hip region

The ICD-10 code S70.01XA is grouped in the following groups for version MS-DRG V38.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2020 through 09/30/2021.

  • 604 – TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC – Relative Weight: 1.4913
  • 605 – TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC – Relative Weight: 0.9092

The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code S70.01XA its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.

  • 924.01 – Contusion of hip (Approximate Flag)




Bruises

Also called: Contusion, Ecchymoses

A bruise is a mark on your skin caused by blood trapped under the surface. It happens when an injury crushes small blood vessels but does not break the skin. Those vessels break open and leak blood under the skin.

Bruises are often painful and swollen. You can get skin, muscle and bone bruises. Bone bruises are the most serious.

It can take months for a bruise to fade, but most last about two weeks. They start off a reddish color, and then turn bluish-purple and greenish-yellow before returning to normal. To reduce bruising, ice the injured area and elevate it above your heart. See your health care provider if you seem to bruise for no reason, or if the bruise appears to be infected.

  • Bleeding into the skin (Medical Encyclopedia)
  • Bruise (Medical Encyclopedia)


[Learn More in MedlinePlus]

  • FY 2021 – No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 – No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 – No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 – No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 – No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 – New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)




Hip Pointer Injury: Causes, Treatment, and Prevention

A hip pointer injury is an extremely painful injury to the iliac crest of the pelvis. The iliac crest is the upper ridge of the ilium, the largest part of the hip bone. A hip pointer injury is characterized by bruising and usually causes bleeding into the hip abductor muscles. The pain may be felt when walking, laughing, coughing, or even breathing deeply.

Causes

Hip pointer injuries are most commonly associated with contact sports, although they can occur with any blunt force injury or severe fall. Hip pointers are common in football and soccer but also occur in hockey, skiing, cycling, rugby, lacrosse, volleyball, and even basketball.

Hip pointers are referred to as contusions (the medical term for bruising). They are caused by the crushing of soft tissues along the iliac crest, either from a direct blow or a fall to the ground.

Many hip pointer injuries are caused by the absence or improper placement of protective sports equipment, especially with football and hockey.

Symptoms

Hip pointer injuries are characterized by immediate and often excruciating pain. This will be followed by localized swelling and bruising, sometimes severe. Within a short span of time, there will be a rapid decline in the strength and range of motion of the affected hip and leg. There may also be muscular spasms. The pain tends to worsen with movement.

Diagnosis

A hip pointer injury is usually self-apparent and readily diagnosed with a physical exam. Laboratory tests are usually unhelpful in diagnosis of a hip pointer injury. However, doctors order imaging studies to determine the severity of the condition if they are concerned about serious injury. Among the options:

  • X-rays can help identify a bone fracture. X-rays can also show if there is bone tissue forming inside the injured muscle, a condition referred to as myositis ossificans.
  • Computed tomography (CT) scans may be ordered if the pain is especially severe or there is persistent pain following treatment.
  • Bone scans (bone scintigraphy) may be ordered to exclude a fracture if the X-ray findings are inconclusive.

Treatment

Most hip pointers will heal with conservative treatment. Like other soft tissue injuries, a hip pointer can usually benefit from a POLICE treatment plan. This is the acronym for Protection, Optimum Loading, Ice, Compression, and Elevation. The general guidelines for the POLICE plan are as follows:

Protect

As soon as you are injured, stop the activity and rest for a few days if needed. After a few days, gentle motion can be started while you still maintain a level of protection for the injured area. During this time you may require some sort of assistive device, like crutches, to walk if you’re experiencing a lot of pain and discomfort. 

Optimum Loading

While you are protecting your injury, gentle motion can, and should, be started. For example, going for short walks and performing some active range of motion exercises for the hip (within pain tolerance) would be beneficial. This progressive loading of your injury can help promote healing. It can also help prevent the joint and muscle tightness and muscle atrophy that can delay your return to your prior level of function.

Ice, Compression, and Elevation

Elevate the injured hip and leg above your heart when you can. Doing so can help reduce pain and discomfort. Because the area involved is so large, compression of the injury is usually not practical.

However, you can ice the area. Apply an ice pack to the injury for 10 minutes, then remove for 10 minutes. Repeat this as often as possible for the first 24 to 48 hours. To avoid frostbite, place a cloth barrier between the ice and your skin, and keep the ice pack moving.

Pain Relief

To ensure the injury heals properly, avoid any aggravating activities that cause significant pain or discomfort for the first one to two weeks. Ice and nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation for the first seven to 10 days. Moderate activity, including walking and range of motion exercises, may be used to restore joint mobility once you are fully on the mend.

If it does not heal with conservative treatment, some doctors will treat a severe hip pointer injury with an anesthetic injection. However, this should be a last resort. 

The one thing you will want to avoid is returning to sports too quickly. This is why doctors are reluctant to treat a hip pointer with cortisone shots, as they can mask symptoms and increase the risk of re-injury. If you’re having trouble getting back to sports and activities, seek out personalized physical therapy for additional treatments and rehabilitation.

Prevention

It is often impossible to avoid an impact during a sports competition, so being well-protected is the best way to prevent serious injury. Wearing properly fitted protective equipment, including hip pads, is the first and best step.

Athletes who wear hip pads need to ensure that the pads are large enough to cover the crest of the hip bone. Today, you can buy compression shorts with built-in hip and thigh pads. They are available at many sporting goods stores and can be used by athletes in nearly every sport.

Hip Pointer – Symptoms, Diagnosis, Treatment and Recovery Exercises

By James M. Paci, MD

A hip pointer is a contusion, or bruise, of the iliac crest, the bone along the brim of the pelvis, and its surrounding structures. Other affected structures may include the tensor fascia lata, the external oblique muscle and the greater trochanter of the femur.  In severe cases a hematoma, a collection of blood, may form and cause a palpable fluctuant mass beneath the skin. Hip pointers are usually the result of a direct blow to the pelvic brim, often in contact sports like football or ice hockey, or after a fall directly onto the hip. 

Symptoms of hip pointer 

A hip pointer is associated with pain over the iliac crest, bruising and hematoma may also occur, as may muscle spasm. In the case of a hematoma, a hip pointer may be associated with severe pain, as it dissects between the gluteus muscle and the iliac crest and can potentially press on the femoral or lateral femoral cutaneous nerves. 

Diagnosing a hip pointer 

While a hip pointer may be diagnosed clinically, in certain instances additional information may be garnered from imaging. Radiographs help to make sure that no fractures have occurred, while MRI and ultrasound may be used to determine the extent of the contusion and or hematoma present. X-rays are especially important in the adolescent patient who may have an avulsion fracture that mimics a hip pointer clinically.

Anatomy of the pelvic brim

The pelvic brim, or iliac crest, is the very superficial bony prominence felt beneath the skin on one’s side at the level of the belly button. It is a part of the pelvis girdle, and has attachments for many muscles, including the internal and external obliques, the tensor fascia lata, the gluteus medius, the latissimus dorsi, and the paraspinal muscles.

Treatment for Hip pointer

The acute treatment of a hip pointer includes rest, ice and use of anti-inflammatory medications like ibuprofen or naproxen.

More Information: Read about sports injury treatment using the P.R.I.C.E. principle – Protection, Rest, Icing, Compression, Elevation.

Crutches may be needed for a couple of days after injury. It has been suggested to delay treatment, other than with ice, for 48 hours to allow all bleeding to stop prior to treating a deep contusion any further. An acute injection of corticosteroids (ie hydrocortisone) into the injured area may greatly reduce symptoms in the short term and speed up rehabilitation. There is however the risk of disordered muscle healing after corticosteroid injection, and as such decision to use this modality must be made on a case specific basis, with the athlete’s best interest in mind. Needle aspiration, or draining of, a painful hematoma may improve symptoms and decrease time to recovery. Physical therapy may be needed to regain motion and strength prior to return to play.

Prognosis of a hip pointer 

Return to play ranges based on the severity of injury, and treatment modalities used. With conservative treatment and physical therapy, on average one can expect full recovery within two to four weeks. An injured athlete may return to play once full range of motion and strength have returned.

Complications of a hip pointer 

Potential complications include muscle fibrosis, delayed muscle soreness, and myositis ossificans (bone formation after hematoma within a muscle).

How can an athlete prevent a hip pointer? 

Proper fitting padding and protective equipment can help prevent injury occurrence or recurrence. 

Hip Exercises 

References:

  • Anderson, K., S. M. Strickland, and R. Warren. “Hip and Groin Injuries in Athletes.” Am J Sports Med 29 4 (2001): 521-33. Print.
  • Arendt, Elizabeth A., American Orthopaedic Society for Sports Medicine., and American Academy of Orthopaedic Surgeons. Oku Orthopaedic Knowledge Update. Sports Medicine 3. 3rd ed. Rosemont, IL: American Academy of Orthopaedic Surgeons, 2004. Print.
  • DeLee, Jesse, David Drez, and Mark D. Miller. Delee & Drez’s Orthopaedic Sports Medicine : Principles and Practice. 3rd ed. Philadelphia: Saunders/Elsevier, 2010. Print.

What is a muscle contusion?

Muscle Contusion (Bruise)

A Muscle Contusion causes swelling and pain, and limits joint range of motion near the injury. … The injured muscle may feel weak and stiff. Sometimes a pool of blood collects within damaged tissue, forming a lump over the injury (hematoma). In severe cases, swelling and bleeding beneath the skin may cause shock.

Athletes in all contact sports have many opportunities to get a muscle contusion (bruise). Contusions are second only to strains as a leading cause of sports injuries.

Most contusions are minor and heal quickly, without taking the athlete away from the game. But, severe contusions can cause deep tissue damage and can lead to complications that may keep the athlete out of sports for months.

Cause

Contusions occur when a direct blow or repeated blows from a blunt object strike part of the body, crushing underlying muscle fibers and connective tissue without breaking the skin. A contusion can result from falling or jamming the body against a hard surface.

Symptoms

Contusions cause swelling and pain, and limit joint range of motion near the injury. Torn blood vessels may cause bluish discoloration. The injured muscle may feel weak and stiff.

Sometimes a pool of blood collects within damaged tissue, forming a lump over the injury (hematoma).

In severe cases, swelling and bleeding beneath the skin may cause shock. If tissue damage is extensive, you may also have a broken bone, dislocated joint, sprain, torn muscle, or other injuries.

Contusions to the abdomen may damage internal organs.

Doctor Examination

See your doctor right away for complete diagnosis. A physical examination will determine the exact location and extent of injury.

Diagnostic imaging tools may be used to better visualize inside the injured area of your body. These tools include ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) scans.

For some injuries, your doctor may also need to check for nerve injury.

Treatment

To control pain, bleeding, and inflammation, keep the muscle in a gentle stretch position and use the RICE formula:

  • Rest. Protect the injured area from further harm by stopping play. You may also use a protective device (i.e., crutches, sling).
  • Ice. Apply ice wrapped in a clean cloth. (Remove ice after 20 minutes.)
  • Compression. Lightly wrap the injured area in a soft bandage or ace wrap.
  • Elevation. Raise it to a level above the heart.

Most athletes with contusions get better quickly with simple treatment measures. Your doctor may give you nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, or other medications for pain relief. Do not massage the injured area.

During the first 24 to 48 hours after injury (acute phase), you will probably need to continue using rest, ice, compression bandages, and elevation of the injured area to control bleeding, swelling, and pain. While the injured part heals, be sure to keep exercising the uninjured parts of your body to maintain your overall level of fitness.

If there is a large hematoma that does not go away within several days, your doctor may drain it surgically to speed healing.

Rehabilitation

After a few days, inflammation should start to go down and the injury may feel a little better. At this time, your doctor may tell you to apply gentle heat to the injury and start the rehabilitation process. Remember to increase your activity level gradually.

Depending upon the extent of your injuries, returning to your normal sports activity may take several weeks or longer. If you put too much stress on the injured area before it has healed enough, excessive scar tissue may develop and cause more problems.

In the first phase of rehabilitation, your doctor may prescribe gentle stretching exercises that begin to restore range of motion to the injured area.

Once your range of motion has improved, your doctor may prescribe weightbearing and strengthening exercises.

When you have normal, pain-free range of motion, your doctor may let you return to non-contact sports.

Return to Play

You may be able to return to contact sports when you get back your full strength, motion, and endurance. When your doctor says you are ready to return to play, he or she may want you to wear a customized protective device to prevent further injury to the area that had a contusion.

Depending upon your sport, you may get special padding made of firm or semi-firm materials. The padding spreads out the force of impact when direct blows from blunt objects strike your body.

Complications

Getting prompt medical treatment and following your doctor’s advice about rehabilitation can help you avoid serious medical complications that occasionally result from deep muscle contusions. Two of the more common complications are compartment syndrome and myositis ossificans.

Compartment Syndrome

In certain cases, rapid bleeding may cause extremely painful swelling within the muscle group of your arm, leg, foot, or buttock. Build-up of pressure from fluids several hours after a contusion injury can disrupt blood flow and prevent nourishment from reaching the muscle group. Compartment syndrome may require urgent surgery to drain the excess fluids.

Myositis Ossificans

Young athletes who try to rehabilitate a severe contusion too quickly sometimes develop myositis ossificans. This is a condition in which the bruised muscle grows bone instead of new muscle cells.

Symptoms may include mild to severe pain that does not go away and swelling at the injury site. Abnormal bone formations can also reduce your flexibility. Vigorous stretching exercises may make the condition worse.

Rest, ice, compression, and elevation to reduce inflammation will usually help. Gentle stretching exercises may improve flexibility. Surgery is rarely required.

BoulderCentre can help. Call us (303) 449-2730 and ask to see one of our sports medicine specialists or choose from any one of our many surgical or general health practitioners.

Article courtesy of AAOS: American Academy of Orthopedic Surgeons.

Contusions of the pelvis, hip joint and upper thigh

Bruise (Latin contusio) – closed, that is, not accompanied by a skin wound, damage to tissues and organs without significant disruption of their structure. This means that when bruised, there are no tears or tears of tendons, muscles, ligaments and other soft tissue structures. The bruise can be accompanied by damage to the blood vessels, which, in turn, will lead to a hematoma, i.e. true accumulation of blood in the cavity after injury or bruising (bruising), when the bruised tissue is evenly soaked with blood.Bruising at the site of injury usually manifests itself as a blue-purple spot, the color of which gradually changes to greenish and yellow over several weeks. If we talk about bruises of the pelvis, hip joint and upper thigh, then soft tissues above the bony protrusions are more often affected. Most often, the injury occurs in the area of ​​the greater trochanter of the femur – the most prominent bone formation on the thigh, but the injury can also be in the area of ​​the iliac crest, the branch of the pubic bone, the sciatic tubercle, or along the entire antero-outer surface of the thigh.

The cause of the injury is very commonplace – a blow that occurs during a fall, collision in sports, traffic accidents, work injuries, etc.

The main complaint of is pain at the site of the injury. At the same time, the ability to move the leg due to the absence of violation of the structure of muscles, tendons, ligaments is preserved, but it can be very painful.

Treatment focuses on relieving pain and maintaining strength and mobility in the joint until symptoms disappear.At the same time, it is important to exclude other, more dangerous damage, which we will discuss below.

Possible complications – subfascial hypertensive syndrome, ossifying myositis.

Typical bruising sites are located in the region of the bony protrusions: front view

Typical bruising sites are located in the region of the bony protrusions: front view

Diagnosis

The diagnosis of a bruise of the pelvis, hip, hip joint may not be as simple as it seems, since other, outwardly imperceptible injuries can occur during impacts.In any case, first tell your doctor about how the injury occurred. After that, the doctor proceeds to the examination. The pain at the site of injury increases with pressure and with tension of nearby muscles. With bruises in the area of ​​the ischial tuberosity, pain is limited only to the posterior thigh muscle group, and with bruises in the anterior thigh, the quadriceps muscle of the thigh. Since almost all of the muscles located here are involved in walking, lameness usually occurs. Edema or subcutaneous hemorrhage is possible.Sometimes pain occurs with passive leg movements, i.e. not when the patient moves the leg independently, but when the doctor moves the patient’s leg. With passive movements in certain positions, the affected soft tissues or the muscles adjacent to them are stretched, which leads to increased pain. Thus, bruises in the iliac crest are accompanied by pain with active abduction and passive adduction of the thigh, and bruises of the anterior surface of the thigh are manifested by pain with active extension of the lower leg and flexion of the hip.

Additional diagnostics may be required to rule out more serious problems. X-rays are taken to distinguish between bruises and fractures visible on radiographs. First of all, it is necessary to exclude fractures of the femoral head, the edges of the acetabulum, fractures of the femoral neck (femoral neck fracture), trochanteric region.

Of other methods of radiation diagnostics, only magnetic resonance imaging provides valuable information. With its help, it is possible to detect hematoma, Morel-Lavallée syndrome (traumatic detachment of the skin and subcutaneous fat), muscle detachment, rupture of the articular lip, stress fracture of the femoral neck and other minor fractures missed during radiography.However, they resort to magnetic resonance imaging, as a rule, not immediately, but only when the usual conservative treatment does not give the expected results.

There are no specific diagnostic tests for injuries. However, if there is severe edema, especially in the upper thigh and in the gluteal region, it is necessary to make sure that subfascial hypertensive syndrome (otherwise known as case syndrome) has not developed, that is, that there is no infringement of the affected muscles in their osteo-fascial beds.To do this, measure the pressure in these beds. According to a number of recommendations, an increase in subfascial pressure up to 30 mm Hg. Art. or to a level less than 30 mm Hg. Art. below diastolic blood pressure is an indication for fasciotomy – an operation during which the fascia is cut, which reduces the pressure inside the fascial sheath. Nevertheless, it must be borne in mind that even with such a high subfascial pressure, expectant tactics give good results in some cases.

Complications

Complications of bruises are rare.One of these complications is the already mentioned subfascial hypertensive syndrome, accompanied by muscle fibrosis (gradual replacement by connective tissue) and a decrease in the range of motion. Another possible complication is the development of ossifying myositis, a condition in which ossification is formed inside the muscles, i.e. areas of calcification, ossification. To prevent ossifying myositis, early mobilization (movement is necessary) of the victim is carried out and measures are taken to prevent the development of hematoma.The formed hematoma can eventually calcify and is clearly visible on radiographs and computed tomograms. It is distinguished from soft tissue sarcoma by the X-ray picture and the presence of trauma in the past. Ossifying myositis develops in a centripetal direction: first, a belt of calcifications is formed, which then expands inward. If myositis does not cause complaints, you can ignore it; if it is accompanied by pain or significant limitation of movement in the joints, then the newly formed bone masses after maturation are removed surgically.Maturation of ossificates occurs within several months and is best determined using a special diagnostic method – scintigraphy.

Ossifying myositis. Muscle areas “ossified” after injury

It is important to mention another important condition, which is not a complication of bruising, but rather a special form of bruising – Morel-Lavallée syndrome (traumatic detachment of the skin and subcutaneous fat). A separate article on our website is devoted to this syndrome.

Treatment

In the vast majority of cases, injuries of the hip, pelvis and hip joint are successfully treated conservatively, that is, without surgery. The goal of conservative treatment is to restore full range and strength of motion in the injured leg as soon as possible. Treatment begins with conservative measures to combat pain and swelling. This includes rest, cold compresses, and nonsteroidal anti-inflammatory drugs (voltaren, xefocam).If standing or walking is painful, crutches can be used. After 1-2 days, they begin to restore leg mobility with passive muscle stretching exercises. You can immediately start treatment with stretching the affected muscles, for which the leg is immobilized in the appropriate position – for example, if the upper part of the quadriceps muscle of the thigh is bruised, the knee joint is often fixed in a bent position. Along with stretching the affected muscles, exercises are prescribed to strengthen the surrounding muscles.Gradually, the strength and mobility of the leg is restored, and the victim returns to sports.

Surgical treatment for bruises is usually not required. Only in rare cases is it necessary to open a hematoma or perform a fasciotomy due to an increase in subfascial pressure.

Severe edema and ineffectiveness of conservative treatment indicate a possible large hematoma, which prevents the rapid healing of the bruise. In such cases, an MRI scan is performed and, based on its results, the issue of draining the hematoma is decided.

Forecast

The prognosis for most bruises is good, but it is difficult to predict how long it will take to recover from a bruise. It depends on the location and severity of the injury and the characteristics of the body.

Prevention

In young people , bruises inevitably accompany sports, especially in such violent forms as American football, hockey or rugby. It is hardly possible to completely prevent them, but some of them can be avoided with the help of protective equipment.Hockey players, for example, wear special protective shorts to protect the pelvis and hips from injury; similar shorts with sewn-in protective shields are worn by American football players. Other pieces of protective equipment, such as shoulder pads, reduce the likelihood of hitting another player’s pelvis and hip when hitting them. The surface of the playing field can also be an important factor. So, there is an opinion (not supported, however, by research data) that when playing on the grass there are fewer bruises than when playing on artificial turf.

In the elderly , bruises usually occur with falls. Remove rugs and electrical wires on the floor from where you will be walking. If it is not possible to remove carpets from the floor, make sure that the corners do not bend. Double-sided tape can be glued to the underside of the corner of the carpet. Walk around your apartment or house with your relatives as a “sleuth” or security specialist: remove or double-sided tape tape the corners of all rugs so that you cannot trip over them.If you have parquet at home, check all of its planks so that none of them fall out. If falls in general happen quite often due to various reasons, then all the more pay special attention to safety. Imagine that a “child” should appear in your house in terms of movement around the apartment: plan so that there is something to hold on to (but the support should be stable, not a plastic shelf) and there is nothing to stumble over. Glue the sharp corners of tables and other furniture with special soft pads (sold in children’s stores).Provide adequate illumination for all rooms and corners in your home.

In the preparation of the article the following materials were used:

Anderson K et al: Hip and groin injuries in athletes. Am J Sports Med 2001; 29 (4): 521.

Diaz J A et al: Severe quadriceps muscle contusions in athletes. A report of three cases. Am J Sports Med 2003; 31 (2): 289.

The author of the article – Candidate of Medical Sciences Sereda Andrey Petrovich

How to know the primary symptoms of a hip fracture?

After 55-60 years of age, a person is trapped not only by diseases of internal organs: his mineral metabolism is also disrupted, as a result of which his bones become fragile.And minimal trauma – a fall on a soft surface, a hit in a vehicle, or even an unsuccessful coup in bed – can cause a fracture. The most common violation of the integrity of a bone such as the femoral neck. Its trouble with people over 55 is that its independent consolidation does not occur. Therefore, we will tell you what are its symptoms in the elderly. If you find them, you urgently need to contact a traumatologist.

The danger of this fracture

It is this injury that most often occurs in old age, which is associated with anatomical features:

  • is the thin area between the head of the bone, which is mostly inside the joint, and the body of the bone running almost vertically.Thus, this structure has a heavy load;
  • feeds on only one artery, which “overgrows” by old age.

The latter makes it impossible for the fracture to heal independently in this area. Therefore, you need to know the signs of a hip fracture in the elderly in order to avoid immobilization, with the help of timely assistance, and with it:

  • Deep vein thrombosis of the thigh and lower leg;
  • bedsores;
  • hypostatic pneumonia;
  • sepsis;
  • disorders of the heart.

Symptoms in the elderly

Basic is pain with the following characteristics:

  • localized in the projection of the hip joint;
  • giving to the crotch area;
  • moderate;
  • aching;
  • aggravated when moving, and especially when leaning on the injured leg;
  • which can almost completely disappear while lying down.

Feeling of the affected hip joint is painful.And if you ask a person lying in bed to raise his leg, he will not be able to tear the outer edge of the foot from the horizontal surface.

Pain does not prevent a person from moving for a while, but it is noticeable that he spares the injured leg. He takes a small step with her, does not put his foot on the heel, tries to quickly step with his healthy limb in order to transfer support to it. Over time, the pain becomes stronger, and in order not to endure it, a person tries to spend more and more time in a supine position.

In addition, there are other symptoms.So, in the prone position, there can be a noticeable decrease in the length of one leg relative to the other. The diseased leg is sometimes turned toe out. Friction of bone fragments can be heard when walking.

Please note that the first signs may appear after a minor injury, awkward turning in bed, sneezing when in an uncomfortable position. Therefore, always pay attention to seemingly such minor complaints from your middle-aged parents. Especially if it’s a mom who is over 55 years old.Fracture should also be suspected primarily in smokers, obese people, diabetes mellitus, and BPH in the elderly.

Treatment of this injury in old age is only operative (endoprosthetics). After that, it is imperative to draw up the correct treatment program.

90,000 Rehabilitation treatment in traumatology and orthopedics – Module from the sovetnmo.ru system. 2 parts (8 tasks): test of continuing medical education

2 ZET

Part 1
Problem 1
A 45-year-old patient had a fight with a neighbor, got hit with a blunt object on the shoulder.When contacting the clinic 2 hours after the incident, he complains of pain and swelling in the area of ​​the right shoulder. On examination: on the anterior surface of the shoulder, a hematoma of about 15 cm in size is determined, the function of the limb is impaired.
What is the treatment of soft tissue injuries on the first day after the injury?

Correct answer: Ensuring rest of the limb, preventing bleeding, apply a soft pressure bandage, ice pack

Problem 2
A 58-year-old patient, who fell on the spot, received a bruise of the thigh area.I went to the polyclinic at the place of residence, where a hematoma of the right thigh was diagnosed, and treatment was prescribed. From the 2nd day, the patient began to attend physiotherapy sessions. To reduce pain and accelerate the resorption of hemorrhage, eliminate edema on the 2nd day after the injury, ultraviolet irradiation was prescribed, which began with 2-3 biodoses. A day later, the dosage began to be increased, in each procedure by 0.5-1 biodose. The patient received no other treatment. On the 10th day from the moment of injury, persistent edema and pronounced induration are observed in the area of ​​the hematoma.
What is the further tactics of physiotherapy treatment?

Correct answer: Peloid therapy

Problem 3
A 40-year-old patient suffered a massive back injury when falling from a height. An ambulance was delivered to the emergency department with complaints of back pain. On examination, there is an extensive hematoma in the lumbosacral and interscapular regions. Anesthesia was carried out, cold was applied to the site of the injury. The patient’s condition is stable. From the second day, physiotherapy was prescribed: impulse currents of low frequency, ultraviolet irradiation.On the 4th day, inductothermy was added to the treatment.
What are the features of the use of inductothermy?

Correct answer: Inductothermy is carried out by an inductor-disk or inductor-cable, which is placed over the area of ​​injury

Problem 4
A 30-year-old patient with numerous lacerations was delivered to the emergency department. Fell off a motorcycle about an hour ago. On examination: the victim is conscious, complains of pain and multiple wounds. The heart rate is 110 per minute.Blood pressure is 90/60 mm Hg. Respiratory rate – 18 per minute. On examination: extensive laceration of the left thigh and lower leg, back, bruised shoulder.
What are the primary tasks in the treatment of a patient with soft tissue injury?

Correct answer: All of the above

Problem 5
A 45-year-old patient came to the clinic with complaints of hand injuries. She worked in the country and accidentally cut her forearm. On examination: on the inner surface of the right shoulder, there is a shallow incised wound about 10 cm long.The primary surgical treatment of the wound was performed. In order to fight infection, restore hemodynamics and microcirculation, and stimulate regeneration processes, the wound was irradiated with ultraviolet light.
What are the features of the application of this method of physiotherapy?

Correct answer: 3-4 biodoses are used in one session

Problem 6
A 60-year-old patient fell on her back. I went to the clinic with complaints of back pain. According to the X-ray data of the spinal column, no pathological changes were revealed.On examination: in the lumbosacral region – a hematoma measuring about 20 cm in diameter. Conservative treatment was carried out. On the 4th day after the fall, the hematoma was evacuated.
What is the further treatment tactics?

Correct answer: Electrophoresis of hyaluronidase and 2% potassium iodide solution

Problem 7
Teenager 14 years old. During the descent on skis I lost control. Trying to urgently slow down, he fell on his right arm, unbent at the elbow joint, resting on the palm.At the same time, the forearm seemed to “overstrain”. As a result of this injury, severe pain in the elbow joint appeared. Objectively: the right elbow joint is enlarged, deformed, the ulnar fossa is smoothed. With careful palpation, the olecranon protrudes from behind. The axis of the shoulder is shifted forward. The hand is in a forced half-extended position, the victim holds it with his good hand. Active movements in the right elbow joint are impossible. When trying to passive movements, springy resistance is felt.X-ray examination revealed a posterior dislocation of both bones of the right forearm. The bones of the forearm were repositioned with the fixation of the forearm with a posterior plaster cast. Rehabilitation treatment is planned.
Select the type of physiotherapy that is indicated for the type of injury described.

Correct answer: Low-frequency magnetic field

Problem 8
A young man 20 years old. During a kickboxing competition, he received a strong blow to his left leg. The blow fell in the area of ​​the upper-inner third of the left leg.After the blow, the victim felt severe pain at the site of the blow and was unable to continue the fight due to dysfunction of the limb. Objective data: the left knee joint is moderately edematous, painful in the projection of the lateral lateral ligament of the knee joint. Magnetic resonance imaging of the left knee joint revealed a partial rupture of the peroneal collateral ligament. A traumatologist has developed a conservative treatment scheme for the injury.
Select one of the conditions for successful restoration of knee function.

Correct answer: All of the above

Part 2
Problem 1
A 27-year-old patient fell from a motorcycle, injured his leg. 2 hours after the incident, the victim was taken to the emergency room. The patient complains of damage to the leg and pain in it. On examination: limited swelling on the anterior surface of the right leg, sharp pain on palpation, painful even touching the skin. X-ray findings show no signs of a fracture. A contusion of the tibial periosteum is suspected.
What is the treatment tactics for injury of the periosteum and bone on the first day?
Correct answer: Gauze bandage, ice pack

Problem 2
A 54-year-old patient was diagnosed with chronic periostitis during examination at the local polyclinic. About six months ago I became a participant in a traffic accident. The diaphysis of the right tibia and the ankle were damaged. The rehabilitation course was completed successfully. Currently, the patient’s condition is satisfactory.
What is characteristic of chronic periostitis?

Correct answer: It can be observed as a result of microtraumatization of muscle tendons at the place of their attachment

Problem 3
A young man of 20 years. While playing football, an opponent accidentally hit the patient’s left shin. A week later, he decided to seek medical help in connection with the persistence of pain in the area of ​​the injury. Objective data: on the anterior surface of the left tibia, an extensive hematoma is determined from the level of the knee joint to the lower third of the lower leg, soft tissues in this area are edematous, in the projection of the middle third of the left tibia, a sharply painful non-displaceable formation measuring 4 × 5 cm is determined.Taking into account the X-ray data, a contusion of the periosteum of the left tibia was diagnosed with the formation of traumatic periostitis and subperiosteal hematoma. Prescribed anti-inflammatory drugs and physiotherapy.
Select the basic physiotherapy procedures required to recover from the described injury.

Correct answer: Warming compress, UHF therapy, ultraviolet irradiation, inductothermy, alternating magnetic field, paraffin and ozokerite applications

Problem 4
Male 38 years old.As he fell down the stairs, he hit a metal bar with his left shoulder. As a result of the bruise, severe pains appeared in the left arm. Objective data: the patient tries to press the injured arm to the body. In the middle third of the left shoulder there is swelling, deformation. On palpation, a sharp local soreness and crepitus of bone fragments are determined. Abnormal mobility appeared at the site of injury. The motor function of the shoulder is impaired. With a load along the axis of the humerus, a sharp pain appears in the middle third of the segment.The radial nerve is not damaged, the hand function is preserved in full. X-ray examination revealed a transverse fracture of the left humerus in the middle third without displacement. A plaster cast was applied to the injured limb. Physiotherapy treatment with inductothermy is planned.
Select the most likely biological effect of inductothermy for the type of injury described.

Correct answer: Deep hyperemia, increased lymph and blood circulation, activation of physical thermoregulation processes, decreased excitability of the central and peripheral nervous system, decreased muscle tone

Problem 5
Teenager 14 years old.While playing football, he fell on his left hand with the elbow joint extended and the arm abducted. I felt severe pain in the elbow joint. Objective data: the left elbow joint is enlarged due to edema and hemarthrosis, its contours are smoothed. Movement in the elbow joint is painful and limited, especially sharp pain occurs when the shoulder is rotated. Palpation in the area of ​​the external condyle is painful, crepitus of bone fragments is determined. The axis of the shoulder does not intersect with the line of the condyles at a right angle.Taking into account the data of X-ray examination, a fracture of the external condyle of the left humerus was diagnosed without displacement. A plaster cast was applied to the injured limb. After the fracture had healed, the plaster cast was removed. On examination of the limb, post-traumatic edema was diagnosed.
Choose the best option for eliminating post-traumatic edema after removing the plaster cast.

Correct answer: Magnetotherapy

Problem 6
The builder is 48 years old. Delivered to the emergency room in connection with a fall an hour ago on the left shin of a metal beam.Condition of moderate severity. Objective data: on the anterior-inner surface of the upper third of the left tibia, there is a wound measuring 8 × 5 cm. There is a pronounced deformation and shortening of the tibia. When trying to shift the injured leg, the lower leg bends at the site of injury (pathological mobility). The pulse at the level of the distal parts of the limb is palpable. Sensitivity is not compromised. Taking into account the data of X-ray examination, the diagnosis was made “open fracture of both bones of the left leg in the upper third”Performed transosseous osteosynthesis of the leg bones. In the future, conservative treatment is planned using physiotherapeutic methods of influence.
Select the method of physiotherapy, the use of which is indicated from the first days of postoperative conservative treatment.

Correct answer: Ultraviolet irradiation

Problem 7
Male 45 years old. He fell from a height of 4 m on his heels, while he did not manage to bend his legs at the knee joints. As a result of the fall, severe pains appeared in the lumbar spine, aggravated by movements of the trunk.Objective data: the lumbar lordosis is smoothed, the spinous process of the I lumbar vertebra is somewhat protruded outward, when tapping on it with fingers, pain is determined, the back muscles are tense. Movement in the lumbar spine is limited due to pain. With a load along the axis of the spine, pain in the damaged vertebra increases sharply. Palpation of the spinous processes of the lumbar spine when the patient lies on his back and slowly raises his straightened legs is painful. There are no neurological symptoms.Computed tomography diagnosed an uncomplicated compression fracture of the body of the III lumbar vertebra. Prescribed conservative treatment with the use of a special corset, physiotherapy procedures and therapeutic exercises.
Select the type of movement that is contraindicated for uncomplicated spinal fractures.

Correct answer: All of the above

Problem 8
Worker 54 years old. During work, fell from a height of 2 m onto construction debris.Bruised the lateral surface of the left leg. Delivered to the trauma department. Objective data: the left leg is rotated outward and shortened, the soft tissues of the anterior surface of the left thigh in the projection of the hip joint are swollen. On palpation, tenderness is determined in the region of the greater trochanter and the groin on the left. Positive symptom of “stuck heel” on the left. The axial load is painful. X-ray examination revealed a simple pertrochanteric fracture of the left femur.Osteosynthesis was performed using a dynamic femoral screw. In the future, the use of gravitational therapy is planned. However, when collecting anamnesis, a contraindication for this method of treatment was revealed.
Select contraindication to gravity therapy.

Correct answer: Meniere’s disease

90,000 How to understand that an elderly person has a hip fracture

High trauma is one of the main problems of old age. In old age, the risk of bruises, sprains and fractures increases dramatically.One of the most terrible injuries for an elderly person was and remains a hip fracture.

A hip injury in adulthood requires long-term treatment and complex rehabilitation; a person loses mobility and the ability to lead an active lifestyle for a long time. Fracture of the femoral neck is accompanied by pain not only in the legs, but also in the groin, lumbar region, often causes deformation of the limbs and other similar problems. In especially severe cases, a person can completely lose mobility.Fatalities are known.

Fracture of the femoral neck is not always obvious, as the intensity of pain is moderate. Pain in the hip area is often attributed to other diseases, for example, osteochondrosis. Meanwhile, a fracture that is not healed in time is fraught with serious consequences. Today we will talk about the specific symptoms of a hip fracture in the elderly.

Symptoms of a hip fracture

The fracture occurs at the site where the femur is attached to the pelvic bone.Since this place has a weak blood supply, a fracture of the femoral neck very often does not heal on its own; surgical intervention is necessary. It is for this reason that it is called one of the most dangerous fractures.

Most of the trauma occurs in adulthood. Risk factors are osteoporosis (and other diseases of bones and joints), excess weight, a sedentary lifestyle, lack of calcium in the body, in women – menopause. The poorer general health, the greater the risk that a fall or hit with the hip against a hard object will cause a fracture.In people with weak immunity and advanced osteoporosis, a fracture can occur even with an unsuccessful turn to the side during sleep – this is typical for people over 80 years old.

Main symptoms of fracture

  • The pain is not too intense. It occurs in the groin and lower back, worse when walking or trying to lean on the leg from which there was a blow or fall. It is important to note that with minor injuries, pain may be absent altogether, which significantly complicates the identification of injury.A special indicator of a hip fracture is pain and tingling in the heel, sensations as if the patient had “served a leg”.

  • In the supine position, the deformation of the injured leg can be observed – a shortening of the limb by several centimeters in comparison with the healthy one.

  • Deformation of the position of the foot. In the supine position, the foot is turned outward, the stronger the fracture, the more pronounced the angle of rotation.There is also an asymmetry in the skin folds in the groin area.

  • In case of a fracture, the patient in the supine position cannot tear the heel off the surface of the bed, in especially severe cases, he cannot move his leg at all.

  • Common fracture symptoms. These include swelling, hematoma, deformity in the area of ​​injury, increased body temperature, etc.

In general, it is quite easy to detect a fracture: any deformities in the position of the leg and pain on movement after a fall in adulthood are highly likely to indicate a fracture.You should immediately see a doctor and take an x-ray.

A hip fracture, like any other fracture, can be comminuted and non-comminuted. In some cases, when the injury is minor, a person can continue to lead a normal life, writing off everything as sprains or bruises. However, this will lead to an early deterioration of the condition – the fragments will move, the injury will become more serious. Since the fracture itself in adulthood may not heal with a high probability, loss of mobility and serious bone deformities are possible in the future.

At the slightest suspicion of a hip fracture in an elderly person, you should immediately consult a doctor. Treatment is carried out by an orthopedic traumatologist and, if necessary, a surgeon.

Injuries and bruises: how to provide first aid?


Illustration by Roman Zakharov specially for Informburo.kz


You stumbled while walking, lost balance while cycling, or bumped while cleaning the house.The result is a bruise. This is the most common type of injury, so it is especially important to know how to properly provide first aid in case of injury.

What to look for first?

For bruises. A bruise is an injury to the soft tissues of the body (skin, fatty layer, blood vessels) that occurs due to a fall or hit with a blunt object. The site of the bruise usually hurts a lot, swelling, swelling and bruising appear on it. But do not rush to assess the severity of the injury by the hematoma – people with fragile vessels and the elderly, even with a light blow, have large, frightening bruises.In this case, a head injury, which may be accompanied by a concussion, is most often manifested by a small inconspicuous bump. The absence of bruising does not mean that the injury is harmless. On the contrary, with a slight bruise, the bruise becomes visible almost immediately, and with a deeper injury, the hematoma will appear only after 2-3 days.

How to distinguish a bruise from a fracture?

Contusions are less painful and do not greatly affect performance. For example, if you break your foot, you will not be able to walk.With a bruise, you can move, but this is accompanied by severe pain. At the time of injury and immediately after, the pain is intense, but over time it diminishes and goes away in a few days. Compare the injured limb with the healthy one. With a fracture, the limb is sometimes deformed: it is stretched or, conversely, shortened due to the displacement of the bones, which does not happen with a bruise.


Roman Zakharov for Informburo.kz


How can you help at the scene?

Immobility is the most important condition for a speedy recovery.The less a person moves the damaged part of the body, the more likely it is to avoid the unpleasant consequences of the injury.

If the blow fell on an arm or leg, try to lie down with your limb on a hill and fix it in a calm state. Apply ice to the bruise to reduce the bruise. It is advisable to cool the injury site on the first day after the injury. After a couple of hours, you can apply a tight bandage to the sore spot to squeeze the tissue and prevent the hemorrhage from spreading. It is worth wearing it for at least a couple of days.If the pain persists for a long time, and bruises and swelling grow, be sure to consult a doctor.


Roman Zakharov for Informburo.kz


For what bruises is it better to see a doctor right away?

In case of bruises of the head, face and body of the victim, it is especially important to lay down and leave alone so as not to harm. In the first minutes, a cold compress will also come to the rescue, but in no case should you self-medicate such an injury. The doctor should examine the patient.It is important to understand if the bones and internal organs are damaged.

It turns out that bruises can only be healed by rest?

Pain relievers can be used to speed up recovery and reduce pain and bruising. If the skin at the site of the injury is not damaged and there are no open wounds, it is better to get rid of the pain pointwise. For example, the company JSC “Khimfarm” sells a drug and a gel that help reduce pain. When using an ibuprofen gel, apply a strip of gel and rub gently into the skin until completely absorbed.It has a local analgesic and anti-inflammatory effect mainly due to inhibition of the synthesis of prostaglandins – mediators of pain and inflammation.

If it is too unpleasant to touch the hematoma, take ibuprofen capsules. They have no taste or smell, the shell dissolves quickly, and its contents are easily digested.

Adults and children over 12 years old (over 40 kg) can take 1 capsule up to 3-4 times a day every 6-8 hours. To achieve a faster therapeutic effect in adults, a single dose can be increased to 2 capsules (400 mg) up to 3 times a day (do not exceed the daily dosage).If, after taking the drug for 2-3 days, the symptoms persist or worsen, it is necessary to stop treatment and consult a doctor


Roman Zakharov for Informburo.kz


By the way, what doctor should I go to for bruises?

After providing first aid, it is advisable to see a doctor as soon as possible, even if it seems that the injury is not serious. Go to the emergency room or the emergency room of a hospital where there is a trauma or surgery department.If this is not possible, a therapist or pediatrician can help you, who also need to know the rules of first aid for injuries.

And you can somehow protect yourself from bruises:

To reduce the risk, follow some rules:

  • Choose comfortable shoes with flat or wide heels;
  • In winter, avoid snow-covered paths, under which there may be ice;
  • Carry bags in both hands to distribute the weight evenly;
  • If you feel that you are falling, do not put your hands in the direction of the fall, so as not to break your hands and forearms;
  • If you lose your balance, try to group or bend your legs;
  • It is better to fall on your side and thus distribute the blow to the whole body.









How to recognize a hip contusion: main symptoms, diagnosis, complications. First aid for a bruised hip, treatment features – By Ekaterina Danilova

The thigh is a voluminous part of the body, which consists of the thigh bone (the largest in the body), a layer of muscles, adipose tissue, and skin.

This area is exposed to heavy loads, it is maximally involved in sports, walking, running.

Therefore, a bruise of the hip is a fairly common occurrence.

It is very important to assess the severity of the injury, to figure out when you can cope on your own, and when to see a doctor.

After all, timely first aid is the key to a quick recovery.

Most common causes of hip contusions

Hip injuries can be injured in domestic conditions, and it is also one of the most common injuries for contact sports. The main causes of a hip injury include:

• Impact with a blunt object.This can be a kick, a bat during a fight, or as a result of a heavy object falling: a cabinet, a hammer, an iron.

• Road accident. It is possible to injure your thigh while in the car itself in a collision, although the risk is much greater for pedestrians who get hit by the wheels of the car. The bumper of the car is just at the level of the person’s thigh, so this area suffers in the first place.

• Fall from a height.

• Sports. A thigh injury is one of the most popular injuries among athletes involved in contact sports (wrestling, hockey, rugby, football).

Hip contusion: symptoms

Despite the cause, the patients have the same complaints. Only with a severe degree are all symptoms more pronounced.

• Pain syndrome occurs at the time of injury and gradually increases. When trying to examine a bruise or touch, a person feels acute pain.

• Puffiness. The volume of the thigh increases in comparison with the healthy limb. The affected area protrudes above the surface of the skin, forming a swelling.

• Hemorrhages.At the time of injury, damage to the skin, fatty tissue, muscles, blood vessels, and nerves occurs. The veins cannot withstand such a load, hemorrhages appear. If a large vessel is affected, a hematoma may form.

• Skin discoloration. At the site of the injury, redness appears, which eventually acquires a bluish tint. As he recovers, the color changes to green, then yellow. This phenomenon is associated with the hemoglobin conversion cycle that occurs when red blood cells are destroyed.

• Restriction of movements.The function of the knee, hip joint suffers. When moving, lameness is noticeable; in severe cases, a person cannot stand on a limb.

• If a thigh contusion is large, first aid was not provided in a timely manner, an inflammatory reaction may occur: fever, swollen lymph nodes.

How to determine the severity?

Treatment primarily depends on the severity of the lesion. Agree, with small scratches, bruises, you can treat the wound yourself, in a few days all the symptoms will pass.Severe cases require medical attention. It is imperative to exclude a fracture, if necessary, inject anti-tetanus serum or suture the wound. These manipulations must be carried out in a hospital. To determine the severity, the following criteria are taken into account:

• 1 degree – the blow was weak, small scratches are visible on the thigh, there may be a bruise, there is practically no pain. Even without treatment, symptoms disappear after 3-4 days.

• 2 degree – a characteristic feature is damage to the muscle layer.The bruise is painful, there is swelling, hemorrhage or hematoma.

• Grade 3 – the injury was so severe that the ligaments and tendons were damaged. Limitation of joint mobility is added to the above symptoms.

• 4 degree – the symptoms are dangerous to health, there is an increase in body temperature, an increase in lymph nodes.

First aid for a bruised hip

In most cases, the doctor needs some time to get to the scene.Therefore, you need to be able to provide first aid yourself, so as not to waste precious minutes, to prevent the development of complications. With a mild degree of injury, you can cope on your own without calling a doctor.

The first point is a comfortable position. It is necessary to exclude any load on the leg. For this, it is recommended to sit or lie down comfortably, the limb should remain in an elevated position. You can use a roller, pillow.

An important step is the application of cold, as a result of which vasoconstriction occurs, bleeding decreases.This procedure has an analgesic, decongestant effect. Ice, a cold bottle of water should be applied to the site of the injury, after wrapping them in a scarf, gauze, and a handkerchief so as not to overcool the skin.

To reduce edema, pain syndrome, a tight bandage of the limb is performed. The bandage should be applied carefully and the skin should be of normal color. If the leg turns blue, it is recommended to loosen the bandage.

Scratches are treated with an antiseptic: hydrogen peroxide, brilliant green, iodine.

If you suspect a fracture, severe contusion of the hip, you should consult a doctor.

Doctor’s actions when a hip contusion is detected

Diagnosis of a hip contusion is not difficult. But to prevent complications, the doctor is forced to conduct additional research:

• Examination of the affected area. Touching the skin makes the pain worse. The doctor makes sure of the integrity of the bones, determines the size of the hematoma.

• The doctor may ask you to walk, raise or bend the limb.This is how active movements are evaluated. Passive doctor checks. He bends, lifts, rotates the limb on his own.

• X-rays are recommended to exclude a fracture.

• If the patient is in severe pain, movement is limited, and external signs of bruising are minimal, an MRI scan should be done. Such symptoms indicate a rupture of ligaments, muscles, skin detachment, intramuscular hematomas – all changes that are not visible on an x-ray.

Hip contusion: medical treatment

If you follow the doctor’s recommendations, the symptoms will diminish rather quickly.During the first week after the injury, the limb should not be loaded, it is necessary to provide it with maximum rest. But from 4-5 days, the minimum charge is shown: rotation of the toes, flexion of the limb at the knee joint. Such a load will improve blood flow and lead to rapid recovery.

To reduce swelling, the leg must be kept in an elevated position. During sleep, it is recommended to put a pillow under it. Thus, the outflow of blood will increase, in the morning you can forget about the swelling.

Pain syndrome creates discomfort for the patient.Even minor unpleasant sensations distract from work, make a person irritable. To reduce these manifestations, the doctor prescribes pain relievers. Preference is given to non-steroidal anti-inflammatory drugs (movalis, nise, nimesil, ibuprofen). Means of this group additionally relieve swelling, reduce the inflammatory response.

For topical application, ointments are used (Diklak gel, Fastum gel, Febrofid). They do not have a systemic effect, they affect only the focus of inflammation.It is enough to rub the gel or ointment into the thigh 3 times a day to achieve an analgesic effect.

When the main symptoms decrease, the doctor recommends physiotherapy: electrophoresis with potassium iodide, UHF, magnetotherapy. After several sessions, blood flow improves, hematomas and hemorrhages resolve.

Possible complications of a thigh contusion

A contusion of a thigh does not always pass without a trace. In severe cases, there is a danger to health, there is a risk of infection, wound suppuration.These are nonspecific complications. There are also specific, specific to a particular type of injury.

Case hypertensive syndrome

Each muscle in the body has a kind of case – fascia, which consists of connective tissue. Hip contusion is accompanied by severe edema, muscle volume increases. The fascia is not capable of stretching, because the muscle fibers are squeezed, which leads to their gradual necrosis. This complication is not very common, in most cases it occurs in severe cases.

Ossifying myositis

Despite the frightening name, this condition is not life-threatening. It develops over several months, a person may not be aware of any changes. In the place of intermuscular hematomas in the process of their resorption, islets of ossification are formed. Muscles lose their elasticity, the contractile function is significantly reduced. If the areas are small, there are no manifestations. When they grow large and limit the mobility of the joint, the doctor decides to surgically remove them.To avoid ossifying myositis, it is necessary to identify hematomas in time, to promote their rapid resorption. Physical activity also plays an important role. Already for 3-4 days, it is recommended to perform simple exercises, restore muscle work.

Traumatic skin detachment (Morel-Lavallee syndrome)

Under the influence of a damaging factor of great force, detachment of skin and fatty tissue from fascia and muscles occurs. The space that has formed is filled with blood from damaged blood vessels.The diagnosis can be confirmed with an MRI. Treatment for this complication depends on the severity. In some cases, it is enough to make a puncture (using a needle to remove the contents), if this procedure does not bring a result, surgical treatment is indicated.

Useful links:

tendenitis, sprains, ruptures – Treatment and recovery – Department of Traumatology – State Hospital of the Central Clinical Hospital of the Russian Academy of Sciences

The quadriceps femoris (quadriceps) refers to the anterior thigh muscle group, the extensor muscle, which is responsible for extending the leg at the knee joint.The quadriceps consists of four muscle bundles (heads): rectus femoris, lateral (external) broad muscle of the thigh, medial (internal) broad muscle of the thigh and intermediate broad muscle of the thigh. The longest is the rectus femoris, it originates from the pelvic bone. Together, these muscle heads form a single tendon that attaches to the patella. The tendon is a fairly strong and elastic formation. More vulnerable to injury are the areas where the tendon passes into the muscle or where the tendon connects to the bone.

Types of injuries and damage.

The most common tendon injuries include:

  • Tendonitis is a disease in which tendon tissue becomes inflamed and degenerated. Most often those tendons that regularly and with frequent repetition experience constant physical activity are susceptible to the disease.
  • Sprains are the most common injury in which tendons and muscle fibers are damaged due to physical impact, but their integrity is not compromised
  • Partial tendon rupture, soft tissue integrity is partially preserved
  • Complete rupture of tendon

The main causes of injury.

  • Frequently repetitive physical activity on the same muscle group
  • Age over 40-45 years
  • Household injuries, falls
  • Weakness of the tendons, which is facilitated by a number of factors: tendonitis, chronic diseases (rheumatoid arthritis, gout, diabetes mellitus, infections, etc.), prolonged immobility, taking steroid hormones, etc.

Symptoms of trauma.

A characteristic and primary symptom for all types of tendon injuries is the appearance of sudden severe pain.The following signs are added to it:

  • redness and swelling in the area of ​​damage
  • heightened sensitivity at the site of injury
  • muscle cramps
  • hemorrhage
  • characteristic crunch at the time of injury
  • limited movement of the injured limb
  • full breaks are characterized by the appearance of dips when walking

Diagnostics.