Chest contusion: symptoms and treatment, cracked rib

Chest injuries account for about 10% of all peacetime injuries. Depending on the mechanism of injury, the nature and intensity of the force of the acting factor, various injuries may occur.

There are closed (when the integrity of the skin is not broken) and open injuries (wounds) of the chest, and there are open ones that do not penetrate into the chest cavity (when the integrity of the parietal pleura is preserved), and those that penetrate into the pleural cavity.

Closed and open injuries can be either with or without a fracture of the ribs or sternum, without damage or with damage to the chest organs.

With all types of chest trauma, the depth and rhythm of breathing and normal coughing are disrupted, which leads to hypoxia and possible complications.

Closed injuries occur due to impact, shaking, or compression of the chest. The nature and severity of injuries depend on the mechanism and intensity of the injury.

Chest contusion
Chest concussion
Rib fractures
Treatment for uncomplicated rib fractures
Complications of rib fractures
Hemothorax
Closed and valve pneumothorax
Subcutaneous emphysema
Sternum fractures

General information

Bruising is a fairly common occurrence and not always harmless.
It occurs as a result of direct mechanical influence. The resulting blow leads to damage to soft tissue cells. Most often, with such an injury, the superficial tissues are not ruptured, only rupture of small vessels is noted. However, a very severe injury can lead to serious consequences and complications in the future. Chest injuries are especially dangerous in this context, since vital organs are located in this area, damage to which can occur as a result of a bruise. ICD-10 code for chest contusion is (S20-S29. Chest injuries). A chest injury, as a rule, does not go away without a trace, and if the blow is too strong, a life-threatening condition can develop. At the moment of a very severe bruise or after it, breathing and the heart may stop, since due to a strong blow to the chest area, the functions of two important systems - the respiratory and cardiovascular systems - are sometimes disrupted.

Often a chest bruise causes sharp pain, which intensifies during a deep breath. In the place where the damage occurred, damage and swelling develop. Severe bruising of the ribs can lead to their fracture . Therefore, injuries that cause pain and discomfort in the sternum are indications for hospitalization. The patient may need urgent care and even surgery, which can only be performed in a specialized surgery department. More details about what the consequences of such injuries can be and how to act correctly to help the victim will be discussed in this article.

Identifying Undesirable Effects

Diagnostics consists of carrying out several manipulations aimed at identifying certain phenomena resulting from injury and occurring in the lungs and chest as a whole.

First, the doctor will conduct a thorough examination and interview the patient. If possible, the traumatologist will examine the patient by palpation and measure blood pressure. The doctor must know how the person was injured, as a result of what manipulations, and what exactly happened. You should tell your doctor about the first sensations after the blow. The doctor will check your pulse, listen to your breathing, and assess the condition of the skin, especially in the nasolabial area.

The next stage is hardware examination. For this disease, X-rays and computed tomography are indicated. In most situations, when a patient complains of difficulty breathing or has hemoptysis, the doctor prescribes a puncture for diagnostic purposes.

X-rays give the doctor a complete picture. It indicates the condition of the chest: whether the ribs, spine are intact, or whether the back is injured. An x-ray clearly shows the presence of fluid and air in the lungs. After making a diagnosis, the doctor assigns an ICD-10 code to the disease and prescribes therapy.

Pathogenesis

When the chest is contused, damage occurs in which the integrity of the tissue is not compromised. The mechanism of development of chest contusion varies. Such injuries occur during a fall, after being hit by a hard object, or when a person’s body is pinched on both sides. The severity of the injuries and the mechanism of their development depend on the characteristics of the injury and the type of tissue that was impacted (skin, muscles, bones, adipose tissue, internal organs). It is in the chest that vital organs are located - the lungs and the heart. Therefore, as a result of a blow to the sternum, not only external hematomas , but also very serious damage - rupture of the diaphragm or lung, heart contusion, etc. In such conditions, immediate medical attention is required.

Buy a good ointment for bruises: “Finalgon”

The drug "Finalgon" contains 2 active ingredients at once - nicoboxil and nonivamide. Therefore, it is considered one of the best remedies for relieving pain and counteracting inflammatory processes. Causes a local irritation reaction and quickly relieves pain in the affected areas.

It is used for the symptomatic treatment of various pathologies - lumbago, arthritis, bursitis, acute low back pain, sciatica, arthralgia, for the treatment of the consequences of sports injuries and myalgia associated with increased physical activity. Also used to warm up muscles before starting a workout.

You can buy the product in a pharmacy even without a doctor’s prescription at a price of 450 rubles per 35 g package. It is worth remembering the possible side effects associated with shortness of breath, burning, paresthesia, cough, and allergic reactions. It is also important to understand that the gel should not be used by children under 17 years of age inclusive. Pregnant and breastfeeding women can use the ointment, but only if absolutely necessary and in consultation with a doctor.

Classification

Like other types of bruises, bruises of the sternum, depending on the damage received, can be divided into several degrees.

First , minor damage is noted. There is practically no pain; abrasions and scratches may remain. After a few days, all unpleasant manifestations disappear without treatment.
The second is pain, muscle tissue is damaged, resulting in swelling and hematomas.
Third , in addition to external damage, internal damage to organs may also occur.
The fourth is a serious injury, causing serious damage to internal organs and threatening health.

Causes

A chest contusion occurs from a blow to a hard object, a blow from a fallen object, or compression between two hard objects.

Medical statistics show that chest contusions are a relatively rare occurrence. They make up no more than 15% of all cases of bruises treated by doctors. Most often, such injuries occur due to the following reasons:

Car accidents - as a result of road accidents, drivers who hit their chest on the steering wheel most often suffer from such a bruise.
Falling from height.
Fight - bruise can occur as a result of a blow to the chest with a blunt object or fist.
Household reasons.
Sports activities.
Industrial injuries.

Ointment for bruises with an analgesic effect: “Diclofenac”

The active substance diclofenac is included in a number of analogue drugs:

"Voltaren";
"Diclofenac"
"Ortofen".

These are common anti-inflammatory drugs belonging to the non-steroidal group. For use by adults and children over 6 years of age. Apply to the skin 1 to 4 times a day. Has a local anesthetic effect.

Side effects are rare. They may be associated with dermatitis, erythema, and attacks of bronchial asthma. Use during pregnancy is permissible only in the first and second trimesters. Moreover, a preliminary consultation with a doctor is required. You can buy all diclofenac-based ointments without a prescription.

Symptoms of chest contusion

The characteristic signs of any bruise are, first of all, hemorrhage in the tissue without damage to the skin. But the complex of symptoms of sternum injury depends on the severity of the injuries received. Therefore, the stronger the blow, the more pronounced and intense the symptoms will become.

Signs of a chest contusion may include the following:

Pain in the place where the blow occurred - the pain can be aching, throbbing, or dull. If you experience throbbing pain, this may indicate damage to the nerve endings, as well as a heart injury. Pain can be bothersome both during movement and at rest. There is often an increase in pain when breathing, sneezing, coughing, or talking.
Hematoma - a bruise forms in the place where the soft tissue of the sternum was damaged, since upon impact small capillaries are damaged and bleeding occurs into the subcutaneous tissue. The hematoma may be larger than the affected area. Minor lesions may resolve without bruising.
Swelling – fluid accumulates at the site of injury and swelling forms.

However, such trauma is rarely isolated. Due to the anatomical proximity of the lungs, diaphragm, and heart, the risk of their damage is very high. Most often, a bruise of the sternum is accompanied by:

lung contusion;
bruised ribs, which may result in a rib crack or fracture (complete or partial);
breast injury;
heart bruise.

If such complications occur, then the symptoms after the blow will be more pronounced. In this case, the following symptoms are likely:

Severe pain when breathing, touching, palpating.
The appearance of breathing problems (they indicate damage to the lung or injury to the ribs). Sometimes the pain is so severe that it is difficult for a person to breathe air.
If the injury causes damage to the lungs or pleura, the victim may develop pneumothorax or hemothorax . Pneumothorax is a condition in which a large amount of air collects in the chest cavity, causing compression of the lung. With pneumothorax, there are serious breathing problems, decreased pulse and increased blood pressure , and the development of emphysema under the skin. The man is in serious condition. Hemothorax - when large blood vessels located in the sternum, lungs or abdominal cavity are damaged, blood enters the pleural cavity and thickens there. In this condition, serious increasing breathing problems, severe weakness, headache and other general symptoms are observed. Both of these conditions are very dangerous to health and require urgent medical attention.

Symptoms of bruised ribs immediately manifest as sharp pain and redness of the skin. Later, swelling and hematoma develop. The victim feels a constant dull aching pain, and it increases with sudden movements, coughing, laughing, and deep breathing. The same are the signs of cracked ribs. If a person feels a crunch inside when moving, this may be evidence of a rib fracture. Pain from a chest injury may not go away for a long time.

Tests and diagnostics

A person who has suffered a chest injury needs to be examined by a traumatologist or surgeon. Confirming a bruise is not difficult. But at the same time, it is important to exclude the presence of injuries to the chest organs and ribs, and to promptly detect life-threatening conditions. The doctor uses the following diagnostic methods:

Questioning, medical history - the doctor must find out how the injury was sustained.
Inspection - allows you to get a general impression of the consequences of the injury. The doctor must pay attention to the presence of cyanosis , which is evidence of hypoxia caused by respiratory failure. The presence of subcutaneous emphysema is also determined as evidence of damage to the lung or bronchus, respiratory sounds, etc.
Palpation - performed to determine whether a rib fracture has occurred. Sequential palpation of the ribs and sternum is carried out. The doctor pays attention to the symmetry of the sternum, the nature of breathing, the condition of the neck veins (non-pulsating swollen veins are a sign of cardiac tamponade), etc.
Chest X-ray – allows you to evaluate the condition of the bones of the chest cavity.
MRI - performed if there is suspicion of damage to internal organs. Allows you to assess the condition of blood vessels and soft tissues, and determine internal hematomas.
CT scan allows you to assess the condition of bone structures in more detail.
Electrocardiogram – to determine the condition of the heart. Blood pressure and pulse .

If necessary, other studies are also carried out. It is very important to conduct a complete and comprehensive examination so as not to miss serious internal injuries.

What to apply to a severe bruise: “Viprosal”

This medicine contains the venom of a common viper and auxiliary components - turpentine, camphor and silicylic acid, which provide additional heating of the affected area.

The product serves as an analgesic, inhibits inflammatory processes, and also improves tissue nutrition by dilating blood vessels. You can buy the product without a prescription and can be taken by adults and children over 12 years old.

Side effects include allergic reactions, including itching and swelling. It is worth remembering that Viprosal cannot be used during pregnancy and breastfeeding. It is important to avoid contact of poison with mucous membranes, including eyes, and damaged areas of skin (wounds, abrasions, ulcers).

Treatment with folk remedies

You can use traditional methods aimed at rapid healing of injuries only if a slight bruise has occurred and the absence of serious injuries has been confirmed by a doctor. You can prepare folk remedies for a compress. The selected product should be used every day for 10-14 days.

Herbal tincture for compress. Mix 20 g each of horsetail, bearberry, hernia, bean pods, horsetail, birch buds, cornflower flowers, knotweed and meadowsweet. Pour all the herbs into 0.5 liters of vodka and leave for three days. Use the product as a daily compress.
Tincture of wild rosemary and nettle. Take 100 g of each herb and pour 100 ml of vodka. After 4 days, pour 200 ml of pomegranate juice into the product and leave for another day. Use for compresses.
Tincture of birch buds. Take 100 g of birch buds and 50 g of barberry, mix with 100 ml of vodka and leave for several days. Make compresses every day.
Tincture of St. John's wort and oak bark. Take 20 g of oak bark and marshmallow, 30 g of St. John's wort. Grind the herbs and pour in 0.5 liters of vodka. Leave for 4 days, strain. Use for daily compresses.

Ointment for bruises and injuries: “Apizartron”

"Apizartron" contains bee venom and auxiliary components. It has a pronounced analgesic effect, helps with sprains and bruises. Used to warm up muscles, including during sports activities. Stimulates blood circulation, eliminates symptoms of neuritis and sciatica, as well as rheumatic joint pathologies.

You can buy the ointment at the pharmacy without presenting a prescription. It can be used by both adults and children over 12 years of age (over 6 - with caution). It is not allowed to use during any trimester of pregnancy and during breastfeeding.

If you have an individual intolerance to bee venom, a number of allergic reactions may occur, including redness, swelling, itching and rash. In these cases, it is necessary to replace the drug.

First aid

To minimize the negative consequences of an injury, immediately after the incident you must act as follows:

Apply cold to the affected area by unbuttoning your clothes. A water bottle, a cold heating pad, or a wet towel will do.
If cracked ribs are suspected, a bandage may be applied to the chest. It will reduce breathing movements, which will relieve some of the pain.
If you suspect serious damage, you should call an ambulance.
If a person is unconscious, he needs to be given ammonia to sniff and brought to his senses. If vomiting occurs, tilt the patient's head to the side.
If breathing stops, artificial respiration must be performed immediately.
It is important to understand that even with minor injuries you need to consult a doctor. External signs are not always evidence of the true condition of the victim.

Consequences and complications

The consequences of a chest injury can be very serious. As a result of the blow, such serious consequences as a ruptured lung, ruptured diaphragm, pulmonary hematoma (hemorrhage), and heart contusion are possible.

Lung rupture often occurs due to injury from a broken rib fragment. The causes of lung rupture can be associated with both a strong blow and tissue tension. The consequences of such an injury can be eliminated if you consult a doctor in time.

With a mild injury, the consequence is a hematoma and pain, which sometimes may not disappear for a long time.

Because sternum injuries cause severe pain, patients are sometimes forced to make limited breathing movements (rigidity). A complication of this phenomenon may be hypoxemia or pneumonia .

If hemothorax is poorly drained, a purulent intrathoracic infection is likely.

List of sources

Bagnenko, S. F. Medical care for mechanical trauma of the chest and abdomen at the prehospital stage / S. F. Bagnenko, Yu. B. Shapot, A. N. Tuchunov // Bulletin of Surgery named after. I.I. Grekova - 2007. - No. 2. -S. 47-51.
Tatyanchenko, V.K. Clinical and anatomical aspects in the surgical treatment of chest wall injuries. Educational and methodological manual / V. K. Tatyanchenko. — Rostov-n/D. : Publishing house of Rostov State Medical University, 2006. - 21 p.
Seleznev S.A., Bagnenko S.F. Traumatic illness and its complications. St. Petersburg 2004.