Bruised hand - causes, treatment and possible complications

Injuries to the hand can be different, both in location and in the nature of the damage. They arise in everyday life, during sports and professional activities. Injuries to the hands can lead to structural changes in tissue, including sprains and fractures. Therefore, immediately after injury, it is recommended to contact a traumatologist who will prescribe an X-ray examination and other diagnostic methods to make an accurate diagnosis and assess the extent of damage to the limb.

At the CONSTANTA Clinic, qualified specialists in the field of traumatology with extensive practical experience are always ready to receive you. Even if it seems to you that the hand injury is minor and you can get by with home treatment, you should not take risks - it is better to visit a doctor who will conduct an examination and assess the extent of the damage. Our Clinic is considered one of the best in Yaroslavl, as we have innovative equipment that is actively used for the diagnosis and treatment of diseases. Competent employees are always ready to discuss questions of interest to the patient and provide qualified medical care within the framework of a specific clinical case.

Classification

According to the place of injury, bruises are distinguished:

• industrial (when struck with heavy tools);
• household;
• sports.

Bruises are classified according to location:

• wrists;
• fingers;
• palms;
• wrist joint.

According to the severity of bruises there are:

• lungs (slight redness of the skin at the site of injury is detected);
• medium (subcutaneous hemorrhages are visualized, soft tissues swell);
• severe (severe swelling and extensive hematomas).

The severity of bruises correlates with the severity of pain. Severe bruises are characterized by causalgia - pain of high intensity, radiating to the forearm and shoulder. The range of motion with causalgia may be limited.

Complications after bruises

After a wrist joint injury, the following complications are recorded:

• Contusion of the palmar surface - causes contusion of the ulnar and median nerve. In this area they are located close to the surface of the dermis. In this case, shooting pain occurs in the phalanges and their sensitivity is impaired. They begin to move with difficulty, and the hand takes the shape of a clawed paw. In some cases, surgery is required to cut the carpal ligaments.
• Sudeck's syndrome - occurs with severe trauma or improper treatment. Trophic vascular disorders develop. The hand and wrist joint become very swollen, the surface of the skin becomes cool and shiny, bluish in color, and the nails become brittle and thin. X-ray examination reveals osteoporosis. To treat it, complex therapy is used, using painkillers, vitamin complexes, vascular agents, muscle relaxants, acupuncture, physiotherapy, massage and exercise therapy.

Symptoms

Common signs of this type of injury include:

• pain in the hand, often radiating to the forearm or fingers (with severe injuries);
• subcutaneous hemorrhages (appear after 2-3 hours) and hematomas;
• pain when performing movements (it can be difficult to clench your fingers into a fist);
• swelling;
• a feeling of numbness accompanied by a decrease in various types of sensitivity;
• hyperemia (redness) of the skin.

With hemorrhages in the subcutaneous fat, the phenomenon of “bruise bloom” is characteristic, in which the cherry color turns blue-green and then yellow after four to five days (due to the metabolism of iron-containing blood pyment).

With severe bruising, hematomas localized on the dorsal surface of the hand, in some cases reach significant sizes. The skin at the site may turn blue. Sometimes the skin peels off, forming blisters with hemorrhagic contents.

Severe pain can provoke a sharp decrease in blood pressure, the development of syncope or traumatic shock.

Short description

A hand bruise is a closed injury that affects soft tissue. Damage to the deep layers of the dermis leads to a violation of the integrity of capillaries and small vessels, which leads to hematomas. Abrasions and scratches may appear on the skin, and occasionally open wounds.

There are four degrees:

1. A mild degree is accompanied by minor damage to the epidermis, the hand swells slightly, and the pain is tolerable. The condition does not require specific treatment and goes away on its own after a few days.
2. The second degree is characterized by rupture of muscle fibers, which leads to the formation of subcutaneous hemorrhage and severe pain.
3. The third type is diagnosed when the injury involves tendons and ligaments, and in some cases can be complicated by dislocation.
4. The fourth degree of injury is the most severe. The injury may be accompanied by damage to bone areas, bleeding, and threaten the general condition of the victim. The terminal stage is treated in a hospital under the supervision of medical specialists.

Emergency care and how to bandage a joint

If a bruise is suspected, immediate (within 15 minutes) application of a cold compress to the damaged area is indicated.

Ice placed in a plastic bag and wrapped in cloth works best.

Next, the bruise site is washed with cold water, after which a bandage is applied, then until contacting a traumatologist to verify the diagnosis, the arm must be kept in an elevated position.

To reduce swelling, internal bleeding and immobilize the hand, it is bandaged. Possible dressing options:

• mitten;
• on the hand and wrist (without gripping the fingers);
• on the hand and finger;
• on the hand and fingers like a glove.

When applying a bandage, remember that at least two joints are subject to immobilization. It is permissible to use a Kramer splint or improvised means. In this case, the splint components should not come into contact with the skin to avoid irritation. To do this, they should first be wrapped in a bandage.

In case of severe bruise, the time of wearing a fixing bandage can be 14 days.

Diagnostics

The traumatologist determines the type of injury through questioning and examination of the patient, as well as using hardware diagnostic methods. A presumptive diagnosis is established based on external signs, complaints and details of injury. To exclude possible complications, the following is prescribed:

• radiography, which shows possible changes in the bone structure and excludes a fracture or crack;
• magnetic resonance imaging – to assess soft tissue damage.

How to develop a hand

On the third day after the injury, in order to avoid wasting of the hand muscles, it is recommended to begin performing the following exercises:

• put your hand on the table and drum your fingers on its surface;

• fold your palms, swinging them like a metronome;

• place your palm on the table, pressing your fingers to the surface (the exercise involves trying to lift them up);

• gently squeeze the expander or ball with the fingers of the injured hand;

• take two balls in your palm and rotate them in your hand clockwise and counterclockwise. Ideally they should not collide.

Under no circumstances should you make sudden movements or perform exercises while overcoming pain.

It is advisable to prescribe a massage or self-massage of the hand, which involves lightly massaging the injured hand from the distal phalanges of the fingers to the proximal parts of the hand.

A severe bruise of the hand can also be treated through acupuncture sessions.

Fractures of the bones of the hand

Fractures of the hand bones account for up to 30% of all injuries to the skeletal system. As a rule, the injury occurs in everyday life, when falling with emphasis on the hand. A fracture of the wrist, phalanges of the fingers or metacarpal bones may occur. An accurate diagnosis can be established based on the results of an x-ray examination. Most often, specialists encounter bone fractures as a result of accidental injuries or when heavy objects fall on the hand.

Fractures of the metacarpal bones are open and closed, with and without signs of displacement, multiple, single, intra-articular and extra-articular. They can be combined with damage to other structures of the hand. Medical tactics are selected individually, based on examination data, taking into account the patient’s general well-being, his age and the nature of the injury. Diagnosis of hand injuries includes taking a medical history and conducting certain diagnostic tests. During the examination and communication with the patient, the doctor finds out the approximate time of injury, the patient’s complaints, and determines the presence or absence of motor restrictions.

What can be done at home in different cases

If a fracture is excluded, treatment can be carried out on an outpatient basis under the supervision of the attending physician.

In the first 24 hours after injury (the sooner the better), dry cold should be applied to the damaged area for no more than 10 minutes every 2 hours. Pain-relieving ointments can be applied locally. After 72-96 hours, heat can be applied to speed up the resolution of the bruise.

© khunkorn — stock.adobe.com

Warming can be done using:

• bags of heated salt (dry heat);
• paraffin applications;
• warm baths.

For severe pain, NSAIDs (Ketotifen, Diclofenac sodium, Ibuprofen) are prescribed orally, and NSAID-based ointments (Fastum gel) are prescribed topically, which are applied 1-3 times a day.

To relieve severe pain, narcotic analgesics (Promedol, Omnopon) are used by prescription and under the supervision of a physician.

For severe edema, vitamin C, Rutin, Ascorutin, Quercetin, Troxevasin, Actovegin, Aescusan, Pentoxifylline are used to strengthen the walls of capillaries and improve microcirculation.

Physiotherapeutic methods can be prescribed from the third day after the injury and include:

• UHF currents;
• action by a low-frequency magnetic field;
• Ural Federal District;
• laser therapy.

If there are signs of compression of the branches of the ulnar or median nerves (the branches of the radial nerve are rarely compressed in cases of hand contusion), a blockade using anesthetics (Novocaine, Trimecaine) can be used to anesthetize the innervated areas. For the same purpose, electro- or phonophoresis with anesthetics and Bernard currents are used. Sometimes they resort to surgery.

In order to stimulate regeneration in the presence of damaged tissues, anabolic agents (substances that enhance protein synthesis) are prescribed:

• non-steroidal (Methyluracil);
• steroids (Methandrostenolone, Phenobolin).

Under the influence of anabolic steroids, soft tissues heal much faster. For the same purpose, the following can be used locally:

• biogenic stimulants based on aloe, rosehip, fir and sea buckthorn oils;
• ointments containing Actovegin and Solcoseryl;
• compresses based on a solution of Dimexide, Novocaine and ethanol.

To stimulate rapid resorption of hematomas under the supervision of a hirudotherapist, leeches can be used.

Angioprotectors

Treatment of a bruise of the hand caused by a blow or a fall is carried out to minimize possible complications. They are often provoked by extensive hematomas that arise due to damage to small blood vessels and the release of biological fluids into the subcutaneous tissue. To prevent the development of events in such a negative scenario, immediately after diagnosing a bruise, traumatologists prescribe ointments and gels with angioprotective effects to patients. A course of external agents prevents an increase in the distensibility of blood vessels, the occurrence of venous stagnation, and helps improve lymphatic drainage and microcirculation by increasing capillary resistance. Rapid resorption of hematomas is also ensured by the following clinical effects of angioprotective ointments:

• decrease in capillary permeability;
• decreased adhesion of leukocytes to vascular walls;
• acceleration of tissue regeneration due to the supply of sufficient amounts of molecular oxygen;
• relief of inflammatory processes by enhancing the vasoconstrictor effect of adrenaline;
• blocking the production of free radicals.

The gel Troxerutin and its imported analogue Troxevasin have proven themselves well in the treatment of hematomas. External preparations have a high degree of bioavailability, but no absorption into the bloodstream occurs. After applying the gel-like product, it is quickly absorbed and evenly distributed in the subcutaneous tissue. Contraindications to the use of Troxerutin are intolerance to the active or auxiliary ingredient and the presence of microtraumas on the skin .

In the treatment of bruises, ointments with angioprotective activity must alternate with non-steroidal anti-inflammatory drugs and (or) external preparations with a warming effect. The time interval between their application is 1-3 hours.

Another effective remedy for eliminating hematomas is Hepatrombin - a combined agent with anti-inflammatory, antithrombotic, and regenerating activity. Such a multifaceted therapeutic effect is provided by the combined composition of the drug for external use:

• heparin has a pronounced anti-edematous effect, normalizes blood circulation in damaged soft tissues, and prevents the formation of blood clots;
• allantoin ensures tissue proliferation, accelerates metabolic processes, and relieves inflammation;
• dexpanthenol improves transdermal absorption of heparin, accelerates tissue healing by restoring optimal metabolism.

The composition of the Gepatrombin gel, in addition to the listed ingredients, also includes essential oils of lemon and coniferous trees . They contain a huge amount of biologically active substances - bioflavonoids, phytoncides, saponins. The addition of these herbal components enhances the therapeutic effect of the product by providing an antibacterial and antiseptic effect.

Folk remedies

3-4 days after the injury, the following will help reduce pain:

• Warm sea salt baths (40 g of salt must be dissolved in 1 liter of water; lower your hand for 30 minutes).
• Camphor oil or alcohol tincture of wild rosemary - can be used topically 1-2 times a day.
• Ointment based on honey and aloe – aloe pulp and honey are taken in equal quantities.
• Local application of goose fat.
• Ointment based on egg yolk - raw yolk and 5 g of table salt are mixed, after which the mixture is applied to the skin 3-4 times a day.
• Dressing with Badyaga - freshwater sponge powder diluted in water in a ratio of one to two. The composition is applied to the damaged area. The dressing is changed twice a day.
• Compresses based on: Vegetable oil, edible vinegar (9%) and water - the ingredients are taken in equal volumes (in the first days a cold compress is used, starting from 3-4 days - a warm one).
• Alcohol tincture of horseradish (1:1 ratio with ethanol) – recommended application time is about 30 minutes.
• Crumpled cabbage leaf - the procedure is performed in the evening before bed.
• Slices of raw potatoes - applying a compress is also done at night.

Wrist sprain

Bruise of the ligaments of the wrist joint is most often the result of an injury during sports activities, less often - a fall on the street or at home. The consequences can be serious problems, including the development of deforming osteoarthritis. Sprained wrist ligaments cause severe pain and stiffness of movement. These inconveniences cause difficulties in performing daily work. Symptoms of a wrist sprain include:

• redness of the damaged area;
• swelling;
• diffuse pain of moderate intensity. It intensifies upon palpation;
• increase in volume;
• possible bruising;
• restriction of movement in the joint.

If painful sensations occur, you should go to the emergency room. The doctor will conduct an examination and send you for an x-ray, which will rule out bone fractures and ligament rupture. If you sprain your ligaments, you should:

• Create rest for the arm: limit movements in the joint for up to four weeks, do not bear heavy weights, apply a cast in case of severe pain. If the left wrist joint is bruised (according to ICD - S60), all necessary functions will have to be temporarily performed with the right hand.
• Apply cold - use a heating pad or ice pack to relieve swelling. Hold for 20 minutes, take a break for a third of an hour and repeat the procedure until the ice completely melts.
• General anesthesia - take Pentalgin for three days.
• Local anesthesia - apply pain-relieving ointments to the affected area. You can use Dolgit cream.
• Wear an orthosis on the sore joint or bandage it with an elastic bandage.