How to determine: a bruise or fracture

Fractures and bruises are the most common injuries of people of all ages and ages.The causes of these injuries are very diverse, arising both in everyday conditions, and during sports activities, road accidents or at work.To avoid unpleasant consequences, it is important to be able to accurately diagnose these injuries, as often a mistake is mistaken for a bone fracture and vice versa.From the accuracy of diagnosis depends on the choice of the method of first aid and further treatment of injury, because these very methods are very significantly different.

Table of Contents:

Signs of a fracture

A fracture is a bone tissue injury accompanied by a periosteum disturbance, or without this accompaniment.Fractures are closed, when the skin at the site of the injury is not damaged by bone fragments, or open, when the bone fragments break the integrity of the skin( roughly speaking, the bone is visible in the open wound).Damage to muscles, vessels, nerves and tendons is possible with fractures of both species.

Depending on the fracture line, they are divided into:

• Fragmented,
• transverse,
• longitudinal,
• helical,
• edge and many others.

Virtually any fracture can be both with the displacement of bone fragments, and without it.The easiest way to mix up with a bruise can be marginal or any other fracture without bias.

At the moment of fracture, there is a severe pain, since the periosteum is provided with a large number of pain receptors, which irritate and cause pain.

Note: bruises are also accompanied by pain, but it gradually subside, whereas in fractures the pain syndrome either persists for a long time or increases.The maximum gain occurs when trying to move the damaged part of the body.

In case of a hand injury, squeeze the hand into a fist or take an object is almost not realistic.Strong pain will not let you rest on your injured leg.When the rib fractures, acute pain occurs during the inspiration process or the turn of the trunk.But there are a number of injuries in which functional impairment is poorly expressed.For example, punctured fractures of the femoral or humerus bones, fracture of metatarsal, tibia.

Important! In some cases, for example, when an athlete rolls the adrenaline level, the pain may not be felt at all.

Edema can appear almost instantaneously, and may build up for some time.The duration of the appearance of bruising or bruising depends on the volume of the muscle tissue surrounding the damage: the more muscle mass, the later there will be a bruise.In some types of fractures, soft tissue damage does not occur, and hematoma with edema does not develop.

Features of diagnosing various types of fractures

Open fractures are the easiest to diagnose.Even a person who does not have medical education, after seeing fragments of bone in the wound, can correctly determine the correct diagnosis.

It is not difficult to determine a fracture with displacement: the limb at the fracture site is deformed in the axial or longitudinal projection.With longitudinal deformation, shortening or lengthening of the limb is observed. The axial displacement is determined by the substantial curvature of the damaged part of the body:

• Bone is severely damaged;
• defines a so-called "false joint", in which the angle of bending is very large;
• there is abnormal mobility at the site of fracture.

Some kinds of comminuted fractures are revealed by careful probing, during which there is a crepitation( crunching, like the crunch of snow).To intentionally provoke crepitation and displace fragments of damaged bones categorically is prohibited, as these actions can lead to additional trauma to the periosteum and surrounding soft tissues.

The diagnosis of closed fractures presents the greatest difficulty:

• Preliminarily determine the fracture of limbs can be using the axial load syndrome, in which there is not a strong pressure on the limb in the longitudinal direction.
• In the case of the lower extremities, a slight tapping on the heel is applied, which provokes pain in the area of ​​damage.
• Similarly, hand fractures are detected, only pressure is applied to the wrist or fingers.

In case of bruises, axial syndrome shows negative results.

Important! It should be specially noted that the final diagnosis of the fracture can only be after an x-ray study.

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Signs of injury

A compression injury of the soft tissues of the human body of a closed type is called a bruise.Skin, subcutaneous fat and muscle are susceptible to injury, while their integrity is not violated at all.

The main symptom of the injury is the pain that appears during the injury and gradually subside.Any bruise is accompanied by swelling, which develops during the first day, then gradually decreases and comes to naught.If there is edema, there may be a disruption of the motor functions of the muscles and nearby joints.

Note: the main difficulty of diagnosis is that this symptomatology is characteristic for closed fractures without displacement, and without fluoroscopy or tomography, it is simply impossible to establish an accurate diagnosis.

First aid for bruises is to immobilize the injured part of the body with a tire or a bandage.Then, during the first day, cold is applied and anesthetic therapy is performed.In the future, all the symptoms of bruises gradually disappear.In especially severe cases, heat is assigned to the affected area and other physiotherapy procedures.

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Summing up all of the above, it can be summarized that the injured part of the body must be immobilized as much as possible and as soon as possible to seek qualified help from a trauma doctor.Only in a medical institution, experts will put an accurate diagnosis and prescribe effective treatment.

Yurchenko Andrey, orthopedist-traumatologist