Muscle Contusion

Beiner JM, Jold P. Muscle contusion injuries current treatment options. J Am Acad Orthop Surg 2001 9 227-237. 

Muscle injuries are relatively uncommon in children. Muscle injuries maybe direct (e.g. muscle contusion) or indirect (e.g. muscle strain or tear). 

Soft Tissue Injuries. Some of the more common soft tissue injuries are sprains, strains, contusions, tendonitis, bursitis, and stress injuries, caused by damaged tendons, muscles, and ligaments. A sprain is a soft tissue injury to the ligaments. Certain sprains are often associated with small fractures. This type of injury is normally associated with a localized trauma event. The severity of the sprain depends on how much of the ligament is torn and to what extent the ligament is detached from the bone. The areas of the human body that are most vulnerable to sprains are ankles, knees, and wrists. 

A contusion is an injury to soft tissue in which the skin is not penetrated, but swelling of broken blood vessels causes a bmise. The bmise is caused by a blow of excessive force to muscle, tendon, or ligament tissue. A bmise, also known as a hematoma, is caused when blood coagulates around the injury causing swelling and discoloring skin. Most contusions are mild and respond well to rest, ice, compression, and elevation of the injured area. 

The German E Commission has approved St. John s wort for internal consumption for psychogenic disturbances, depressive states, sleep disorders, and anxiety and nervous excitement, particularly that associated with menopause. Oily Hypericum preparations are approved for stomach and gastrointestinal complaints, including diarrhea. Oily Hypericum preparations are also approved by the Commission E for external use for the treatment of incised and contused wounds, muscle aches, and first degree burns (96). 

A. Oral. Manifestations of acute oral overdose usually occur within 5-30 minutes after ingestion. Burning in the mouth and throat occurs immediately, followed by nausea and vomiting. Ataxia, drowsiness, contusion, restlessness, delirium, muscle twitching, and coma may occur. Camphor typically causes abmpt onset of seizures about 20-30 minutes after ingestion. Death may result from CNS depression and respiratory arrest or may be secondary to status epilepticus. Chronic camphor intoxication may produce symptoms similar to Reye s syndrome. 

An injury is a wound or damage to the body resulting from an event in the work environment. Examples include cuts, punctures, lacerations, abrasions, fractures, bruises, contusions, chipped teeth, amputations, insect bites, electrocution, or thermal, chemical, electrical, or radiation bums. Classify sprains and strain injuries to muscles, joints, and connective tissues as injuries when they result from a slip, trip, fall, or other similar accidents. 

Fig. 4.18. Extended field-of-view ultrasound demonstrates a mass-like organising haematoma following contusion involving the vastus inter-medius (VM) and rectus femoris (RP) muscles. The arrowheads indicate the margins of the echogenic organising haematoma which surround a fluid collection (arrow)...

Numerous clinical studies and published case reports confirm the efficacy of aescin-containing topical products, especially in the treatment of sport injuries, including blunt trauma of the lower limbs, joint sprains, tendonitis, hematomas, muscle strain, traumatic edema, Achilles tendonitis surgical outpatient trauma, including fractures, sprains, crush injuries, and contusions postoperative or postpartum edema in obstetrics and gynecology and others. 

Fig. 3.15a,b. Closed contusion trauma. Two different cases of thigh muscle injuries following blunt trauma by sharp objects, a Transverse 12-5 MHz US image over the vastus lateralis (m) reveals an extensive laceration of muscle tissue filled in with hypoechoic hematoma (arrowheads). Note the intact subcutaneous tissue (s). b Transverse 12-5 MHz US image over the medial thigh demonstrates combined laceration of the subcutaneous tissue (s) and the gracilis muscle (m) with interruption of the fascia (arrows). The defect is filled in with hypoechoic hematoma (arrowheads)... 

Muscle tears can be followed by cystic transformation of the hematoma consisting of an ovoid fluid-filled anechoic cavity with well-defined margins located within the muscle (Fig. 13.28). A significant complication of vastus intermedius tears secondary to direct contusion trauma is myositis ossificans circumscripta, which is also referred to as heterotopic bone formation. This self-limiting condition starts with undefined chronic pain in the middle thigh... 

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