Elbow contusion: symptoms, first aid, treatment, rehabilitation
The content of the article:
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Anatomical features
Blood supply and innervation
-
Symptoms of an elbow joint injury
- Differences between contusion and dislocation
- Differences between bruises and fractures
- First aid
- Diagnostics
- Specialized treatment for bruised elbow
-
Complications
Hemarthrosis treatment
- Rehabilitation
- Video
A bruised elbow is considered one of the most painful bruised injuries. This is due to the anatomical structure of the joint and the superficially located nerve tissue.
An elbow injury usually occurs as a result of a fall or direct impact
A bruised injury to the elbow joint is characterized by the occurrence of pain, hematoma, swelling, and partial impairment of motor function in the bend of the arm.
Injury can be caused by a direct hit or a fall with an emphasis on the elbow.
The danger of this injury consists in the possibility of an incorrect differential diagnosis with neglect of dislocation or fracture of one or more bones, limitation of mobility of the upper limb, the presence of persistent bleeding, hemarthrosis (outflow of blood into the joint cavity), development of contracture, etc.
Anatomical features
The elbow joint is represented by a movable joint of three bones: the ulna and the radius (which make up the forearm) with the humerus.
The elbow joint has a complex anatomical structure
The joint connects three bones to form three simple joints that are enclosed in one capsule. Therefore, in terms of its structure, it belongs to complex joints.
Simple joints that form the elbow:
| Joint | Description |
| Shoulder elbow | Connects the humerus and ulna in a flexible manner |
| Brachioradial | Connects the humerus to the radius |
| Proximal radioulnar | Connects two bones of the forearm in the ulnar region: radial and ulnar |
Thanks to these joints, the following types of movements are possible:
- flexion and extension of the limb around the frontal axis;
- rotation of the radius around the vertical axis (movement inward and outward).
Three bones with three joints combine into one complex elbow joint to form an articular capsule.
The joint capsule or bursa is one of the most important elements of any joint, ensuring their tightness. It is composed of dense fibers, including the ligamentous apparatus and tendons of a number of passing muscles.
The functions of the joint capsule:
- ensuring the tightness of the articular cavity and the strength of its walls;
- secretion of synovial fluid - a kind of lubricant necessary for the normal functioning of the joint, which is carried out by providing nutrition, moisturizing and minimizing friction of the articular surfaces.
The articular capsule of the elbow joint is strengthened with an auxiliary ligamentous apparatus, which includes two ligaments - the radial and ulnar collateral.
Blood supply and innervation
The joint receives the necessary nutrition from arterial blood, which passes along the articular network of the elbow. The articular network is formed from two larger arteries - the upper and lower ulnar collateral arteries, which, in turn, originate from the large brachial artery.
Also, food is received from the branches of the ulnar, deep brachial and posterior interosseous arteries. Venous outflow is carried out through the arteries of the same name. In the elbow area, there are lymph nodes, from which lymph flows into the deep lymphatic vessels.
The elbow is innervated by the branches of three large nerve fibers: the median, radial and ulnar nerves.
Symptoms of an elbow joint injury
In case of mechanical injury or a fall on the elbow, characteristic symptoms may occur. However, it is not always possible to clearly carry out the differential diagnosis of contusion with dislocation or fracture. Therefore, in addition to the clinical picture, the diagnosis (with the exception of minor bruises) must be confirmed by X-ray diagnostic methods.
If you bruise your elbow, you may experience the following symptoms:
- sharp soreness in the affected area that occurs immediately after injury;
- increasing swelling (swelling) of the elbow;
- the presence of a hematoma (bruise);
- joint dysfunction. It should be noted that the movements are usually preserved, but their amplitude suffers (decreases).
The ulnar nerve, passing along the back surface of the elbow, is poorly protected and located in a vulnerable place, reaches the hand and innervates 2 fingers - the ring and little fingers. Even a slight blow to the elbow area can be accompanied by a sensation of a piercing current from the elbow to these fingers.
This indicates a superficially located and poorly protected ulnar nerve, which is often involved in the process when the elbow is injured.
Further development of edema worsens its trophism. This can be manifested by nerve neuropathy, excruciating pain, paresthesias (changes in sensitivity), a burning sensation or numbness in the innervated fingers (fifth and fourth).
Differences between contusion and dislocation
Symptoms of forearm dislocation:
- the presence of gross deformity of the limb;
- more pronounced pain syndrome;
- the inability to perform active hand movements;
- the presence of spring resistance during passive movements.
Differences between bruises and fractures
Fractures of the bones that form the joint have their own symptomatic features. Most often, there is an intra-articular fracture of the radius, in which its process breaks off - olecranon. The main mechanism of this fracture is a fall with an emphasis on the elbow on a hard surface.
Typical symptoms of a fracture:
- severe severe pain that can spread above and below the injury - in the forearm, hand, fingers;
- lack of physical activity or its significant limitation;
- pathological mobility. It is characterized by the addition of additional mobility in the area of injury, which is normally absent in a healthy person;
- the appearance of crepitus (specific crunch), heard at a distance or with the use of a stethophonendoscope;
- severe edema, hematoma, neurological manifestations (in the form of tingling, numbness in the hand, fingers or forearm).
With a fracture of the ulna bone, the arm hangs limply, it is impossible to perform extensor movements.
First aid
If the elbow is bruised from a fall or from an impact, first aid should be given immediately. Immediately after injury, it is necessary to apply cold to the damaged area in order to relieve pain and reduce swelling. For this, ice, snow, food from the freezer, etc. are suitable. The use of local warming ointments and gels is prohibited.
In some cases, limb immobilization is required
The next step is limb immobilization. The injured arm must be fixed in a bent state or, if the intense pain does not allow bending the arm, a splint should be applied. The main goal is to ensure the immobility of the injured limb.
Immediately after providing first aid, the victim must be taken to a medical institution and seek help from a qualified specialist - a traumatologist-orthopedist or surgeon, for examination, diagnosis, appointment of adequate therapy and rehabilitation.
Diagnostics
The diagnosis is made based on the patient's complaints, medical history, mechanism of injury and additional research methods.
To distinguish a bruise from a fracture, an x-ray is prescribed
X-rays should be taken to rule out other injuries. X-ray will allow visualizing the state of the bones, their integrity, as well as the congruence of the articular surfaces (their correspondence to each other). If it is impossible to evaluate the X-ray image, it is possible to prescribe an X-ray of the intact arm for comparative diagnosis.
In some cases, computed tomography of the damaged connection is prescribed.
Specialized treatment for bruised elbow
Treatment is usually outpatient.
Physiotherapeutic procedures (electrophoresis, iontophoresis, etc.) may be prescribed a few days after injury. Thermal treatments and warm compresses require careful use, as they can become a trigger in the development of various complications.
Complications
Often, a bruise of the elbow can be complicated by hemarthrosis - the outpouring of blood into the joint cavity.
To minimize the development of complications, it is necessary to consult a doctor in a timely manner.
As a result of the fact that the articular cavity is tightly and hermetically closed from all sides by the walls of the articular cavity (articular surfaces), the outflowing blood does not find an outlet, squeezes the supplying vessels, and impairs blood supply. Without timely assistance, this process can lead to the destruction of the articular cartilage at the bend of the arm and the formation of deforming arthrosis.
An extremely unfavorable outcome of hemarthrosis is the formation of contracture.
The accumulated blood triggers the formation of adhesions in the junction, which ultimately leads to a complete lack of movement in the elbow, i.e. contracture, the joint ceases to perform its function.
Hemarthrosis treatment
In the presence of hemarthrosis, a puncture of the joint is performed with aspiration of blood, removal of blood clots, injection of hormonal drugs - glucocorticoids - may be introduced into the cavity.
Hormones are administered to reduce the inflammatory response. However, recently there have been data indicating that intra-articular administration of hormones is not always justified, since they adversely affect the articular cartilage.
The question of the introduction of hormones is decided by the doctor individually, depending on the degree of hemarthrosis and the state of the connection. The first few days after injury, the limb is fixed with a special bandage.
Rehabilitation
Rehabilitation is an important point necessary to prevent the formation of adhesions, contractures and speedy recovery.
Rehabilitation activities should begin as early as possible. After 2-3 days, it is recommended to start gradually doing therapeutic exercises, doing gentle exercises, hand movements.
Correct diagnosis, correct treatment with a short period of immobilization, rehabilitation with an early onset of physical activity in case of a bruised elbow minimize the risk of complications and accelerate the recovery period.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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