Contusion

A contusion is a closed injury to tissues and organs without significant disruption of skin integrity, caused by blunt force trauma or a fall. It is one of the most common types of injury.

In a contusion, the primary damage occurs in the subcutaneous tissues. The impact ruptures small blood vessels, leading to hemorrhage and the formation of a hematoma (bruise). The subcutaneous fat, muscles, and periosteum may also be affected.

Etiology and pathophysiology

A contusion results from direct exposure to blunt force. Pathophysiologically, blood escaping from damaged vessels infiltrates the tissues, causing edema and compressing nerve endings, which produces pain.

Due to the biochemical breakdown of hemoglobin, the color of a hematoma changes over time: initially reddish-blue, it then turns greenish, and finally becomes yellow.

Clinical Significance

The main clinical signs of a contusion are pain, swelling (edema), ecchymosis (hematoma), and partial functional impairment in the affected body part.

First aid for a contusion is aimed at reducing pain, swelling, and bleeding. It is based on the principle known as RICE:

• Rest. The injured limb is immobilized.
• Ice. Cold is applied to the site of injury for 15–20 minutes (through a cloth).
• Compression. A pressure dressing is applied.
• Elevation. The injured limb should be elevated.

It is important to distinguish a contusion from more serious injuries. Severe deformity, inability to bear weight on the limb, or abnormal bone mobility are warning signs that require immediate medical evaluation to rule out a fracture.