A toe bruise is a common trauma that is characterized by damage to the deep layers of the dermis, muscle tissue without violating the integrity of the skin. Damage happens on the street or in domestic conditions. The reason is a hit or fall of a heavy object on the leg. The injured finger swells and hurts, gradually turning into a continuous hematoma. Treatment is prescribed by a traumatologist after differential diagnosis, which is carried out to exclude a fracture of the finger.
In traumatological practice, a bruise is classified as a minor injury. The big toe, along with the little finger, is injured more often than the other toes. As a result of mechanical action, the site of the injury swells, sharp pain appears. This is due to the accumulation of a large number of nerve receptors on the phalanges of the toes.
In addition, a bruise can be combined with more severe injuries (fracture, dislocation), which increases the intensity of clinical signs. Four degrees of severity are distinguished depending on morphological manifestations:
- The first is the lightest, characterized by minor damage. There is a slight swelling, scratches may form against a background of moderate pain. In this case, special treatment is not required, after a few days the finger is restored.
- Damage to the second degree is characterized by the appearance of subcutaneous hemorrhage, the pain syndrome is more pronounced and persists for a long period of time. Edema is localized not only on the foot, but also spreads to neighboring tissues.
- A third degree toe bruise is characterized by a severe course. Injury can be complicated by dislocation. Strong swelling is observed, the finger turns into a solid bruise. The pain is piercing, which intensifies not only during movement, but also when trying to touch it.
- The last (fourth) stage is accompanied by deep wounds, possibly a violation of the integrity of the skin, bone fracture. Serious damage is treated in a hospital setting, where a fracture examination is required.
The toe is damaged under the influence of the following factors:
- if a heavy object falls on your leg;
- sharp kick on a massive object;
- intentionally causing damage to another person.
In most cases, finger injury does not cause serious damage. Typically, the foot is protected by shoes that soften the force of the blow. The situation is aggravated if, at the time of injury, the person’s legs are bare. In this case, a bruise can be combined with other injuries. Severe soft tissue lesions can be obtained during sports training in power sports, in road traffic accidents, during natural disasters.
Clinical symptoms appear immediately after the incident. The severity and number of signs depend on the strength of the impact and its direction. At the time of injury, a piercing pain appears, which may intensify after a while. The increase in intensity is associated with irritation of nerve receptors during the appearance of edema. After some time, the pain syndrome subsides and appears only at the time of physical activity.
Despite significant swelling, motor ability in the phalanges persists. In addition, a bruise of the big toe contributes to the appearance of a hematoma on the foot. Localization of subcutaneous bruising is not limited to the surface of the finger. The hematoma extends to the back of the foot.
Light injuries are accompanied by slight bruising. After a strong blow, deep-lying tissues are injured, so hemorrhage manifests itself within a few days. Depending on the age, the hematoma changes color from violet to bright yellow. A bruised thumb injury may result in damage to the nail plate. The stratum corneum darkens and is torn away from the nail bed.
At first, movements are sharply limited in large part due to edema. As the excess fluid is removed from the soft tissues, the motor function is restored. A bruise does not cause a deterioration in the general condition, combined injuries (fractures, dislocations) cause additional symptoms.
Difference from fracture
In the second and third degree, it is important to conduct a differential diagnosis with a fracture. With two injuries, a different approach to treatment is used, so an incorrect diagnosis can cause complications or improper bone fusion.
Diagnostic measures are carried out by an orthopedic traumatologist, but the initial signs can be suspected independently. The ability to distinguish between injuries can be useful for the provision of first aid, so that inept actions do not aggravate the patient’s condition.
Comparative characteristics of injury and fracture:
- Pain occurs at the time of impact, but with a violation of the integrity of the bones is accompanied by a dull crunch. With a bruise, the intensity of the symptom gradually decreases, which is not typical for a fracture. In case of damage to bone tissue, acute pain becomes chronic, which worries a person and at rest.
- The mobility of the finger is maintained only in the case of a bruised lesion. With a fracture, complete motor dysfunction occurs.
- Swelling is present in both cases. The finger, which has greatly increased in size, indicates the severity of the lesion. With a bruise after a couple of days, swelling decreases, broken bones are accompanied by the accumulation of excess fluid much longer.
- Hematomas occur in all cases, with extensive localization, a violation of the integrity of bone tissue can be suspected.
In addition to general symptoms, with a fracture of the finger, there are distinctive signs:
- when pressed a few centimeters below the base of the finger, sharp pain occurs;
- finger deformation, deviation from the axis;
- crepitus during palpation of the affected area
- with open wounds, fragments of damaged bones may be visible;
- cyanosis of the finger can be replaced by a sharp pallor with a sharp violation of local blood circulation.
A severe bruise of a toe can cause a pain shock in the victim, which, with special sensitivity, can cause loss of consciousness.
Immediately after an injury, a person may need help. Actions should be aimed at preventing the development of intense symptoms.
Algorithm of actions:
- Reassure a person and inspect the site of injury. If the victim is shod, and the shoe sits firmly on his leg, you do not need to remove it. If the finger is bare, assess the degree of injury in appearance.
- An injured limb needs to be completely relaxed by gently resting its foot on a soft roller. In this case, the leg should be located slightly above the level of the heart. Such a measure will not allow the formation of severe edema.
- If possible, a cold object can be applied to the bruised place to prevent edema and subcutaneous hemorrhage.
- The presence of bleeding suggests its stop. To do this, you can use a hemostatic sponge or a pressure dressing method, for which only sterile dressings are used.
- You can reduce pain with the help of non-narcotic anesthetics – Ibuprofen, Ketoprofen.
After carrying out pre-medical measures, deliver the victim to the trauma unit to receive qualified medical care.
It is possible to determine the type and degree of injury only in a medical institution. After an initial examination by a traumatologist, a radiographic examination of the foot is prescribed.
According to the results of the image, a fracture is necessarily excluded. After a complete history and palpation examination, the doctor determines the treatment regimen and recommendations.
A bruised toe is treated in two stages:
- In the acute period (first two days), warming procedures are prohibited. Heat can trigger an inflammatory reaction. The treatment is carried out with painkillers (Baralgin, Ketanov) with a general effect. For local exposure, Nise, Bystrumgel, Dolobene gels are used, which do not irritate the receptors and do not cause local temperature increase. In addition to the analgesic effect, the drugs have a decongestant effect. Cold compresses are prescribed to reduce the edema that has already manifested: ice is applied for 15 minutes every 4 hours.
- Starting from the third day, a bruised finger is treated with heat. For this, warming compresses are prescribed. For the purpose of anti-inflammatory prevention and anesthesia, warming ointments are prescribed – Voltaren, Fastum gel. For resorption of bruises, Lyoton, Troxerutin, Troxevasin are used. The gel is evenly distributed over the surface of the damaged finger, which is absorbed independently.
With a different degree of ailment, recovery occurs after a different period of time. Treatment of the mild stage takes a couple of days, therapy after severe injuries can drag on for several weeks.
Recovery procedures are prescribed after the main therapeutic measures. Improve tissue regeneration will help sessions of laser therapy, UHF, treatment with a pulsed magnetic field. After severe injuries, daily use of orthopedic insoles equipped with a metatarsal roller is recommended.
Often a bruise on the leg is regarded as a minor injury, which is not in a hurry to consult a doctor. As a result, after trying self-treatment, the patient is faced with sad consequences:
- joint inflammation;
- accession of pyogenic infection;
- arthrosis of the thumb;
It is possible to prevent a bruise of the toe, if you observe the following precautions:
- adhere to safety in the workplace;
- for walking on the road, during sports use high-quality shoes;
- Do not engage in extreme sports;
- Do not rush while walking, look under your feet.
If finger injury occurs, consult a healthcare professional to make the correct diagnosis and prescribe an effective treatment.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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