What is a Contusion?

Contusion refers to closed injury caused by blunt effects, mainly with intradermal or / and subcutaneous and soft tissue bleeding. The essence of the contusion is the rupture and bleeding of small veins or arterioles in the soft tissue, and the blood is mainly in the subcutaneous loose connective tissue and the fatty layer. The clinical manifestations of contusion are intradermal or / and subcutaneous blood staining, the size, morphology, and degree of bleeding of the contusion, the depth of the color, and it varies with the force and the characteristics of the local tissue. According to the site of bleeding after contusion, it can be divided into intracutaneous bleeding and subcutaneous bleeding. Subcutaneous tissue usually has less bleeding than dense areas; subcutaneous tissue has more bleeding in loose areas, and even blood accumulates in local tissues to form subcutaneous hematomas.

Basic Information

Visiting department

General Surgery

Common causes

Contusions are the most common closed injuries, and damage to soft tissue under the skin caused by blunt violence (such as buttstock, stones) or heavy objects

Common symptoms

Pain, swelling, dysfunction, etc.

Contusions are the most common closed injuries, and damage to soft tissues under the skin caused by blunt violence (such as buttstock, stones) or heavy objects.
With the prolonged time after injury, the hematoma disintegrates under the action of tissue enzymes, the red blood cell membrane ruptures, and the hemoglobin undergoes a chemical change in color. Hemoglobin breakdown substances include hemin, bilirubin and bilirubin. The color of the bleeding focus (purple, purple-brown or cyan-purple) changes from the edge first, and after 2 days, you can see yellow or green on the edge of the subcutaneous bleeding, or both of these colors. Later, the purple-red, The blue-purple or purple-brown area gradually narrowed toward the center until it disappeared, and the blue-green and yellow replaced it. After 2 to 3 weeks, the yellow or blue-green faded, and the local skin color returned to normal.

1. Pain: It is related to the nature and degree of violence, the distribution of nerves at the injured site, and the strength of the inflammatory response.
2. Swelling: due to local soft tissue bleeding or (and) exudation of inflammatory reactions.
3. Dysfunction: A disorder that causes limb function or activity.
4. Wounds or wounds: Depending on the violent nature and extent of the injury, there can be wounds or skin abrasions of different depths.

Bruises are usually visible to the naked eye, with localized congestion, swelling, and tenderness. Ultrasound, CT and other imaging studies can determine the location, scope and extent.

1. Trauma history.
2. Local symptoms, such as pain, swelling, and inconvenience.
3. Check for signs: local tenderness, positive traction pain.
4.X films are distinguished from fractures.

Treatment methods for minor and severe contusions: A minor contusion only needs local braking, rest, and elevation of the affected limb, which can quickly reduce swelling and heal. Severe bruises can be topically applied with anti-tumor and analgesic drugs, replaced daily, orally administered with drugs to relax muscles and blood, and if necessary use prophylactic antibiotics or anti-inflammatory drugs, while guarding against shock and changes in renal function. Early application of soft tissue contusion has a very good effect, which is one of the characteristics of traditional Chinese medicine traumatology. Patients often have immediate swelling and analgesia after application. The bandage fixation during application can not only keep the joint in a position where the injured ligament is loose, temporarily limit the movement of the limb, but also help to repair the injured ligament and shorten the treatment time. Many patients have been treated with this method for a long time and have received good results.

Contusion has important significance in forensic clinical identification.
1. The location of the bruise marks the point of action of violence.
2. In some cases, the shape of the striking surface or contact surface of the wounded object can be inferred based on the shape of the contusion, especially intracutaneous bleeding. If the stick hits the lower back, a "hollow" subcutaneous hemorrhage may occur, that is, the middle is pale, and two parallel blood bands appear on both sides. The shape of the subcutaneous bleeding can help infer the damage.
3. Based on the change in the color of the subcutaneous hemorrhage, the time elapsed after the injury can be estimated.