CONTUSIONS /SPRAIN /STRAIN

CONTUSIONS:-

A contusion is a soft tissue injury produced by blunt force, such as a blow, kick, or fall, causing small blood vessels to rupture and bleed into soft tissues (ecchymosis or bruising).

CAUSES:-

  • By falls
  • Direct blows
  • Crust injury
  • Motor vehicle collisions
  • Sport injuries.


MANAGEMENT:-

P- Protection
R- Rest
I- Ice
C- Compression
E- Elevation.

STRAIN:-

Injury to a muscle or tendon from overuse, overstretching, or excessive stress may cause strain.

TYPES:-

  1. Acute:- Acute strains can result from a single injurious incident.
  2. Chronic:- Chronic strains result from repetitive injuries. Chronic strains can result from improper management of acute strains.



DEGREES:-

  1. A first-degree strain is mild stretching of the muscle or tendon with no loss of range of motion (ROM).

    Signs/symptoms:
    • Gradual onset of palpation-induced tenderness
    • Mild muscle spasm.


  2. A second-degree strain involves moderate stretching and/or partial tearing of the muscle or tendon.

    Signs/symptoms:
    • Acute pain during the precipitating event
    • Tenderness at the site
    • Edema
    • Significant muscle spasm
    • Ecchymosis.


  3. A third-degree strain is severe muscle or tendon stretching with rupturing and tearing of the involved tissue.

    Signs/symptoms:
    • Immediate pain described as tearing
    • Snapping, or burning,
    • Edema
    • Loss of function.
    • Significant muscle spasm
    • Bone injury
    • Ecchymosis.

Sprain:-

A sprain is an injury to the ligaments the tough bands of fibrous tissue that connect two bones together in your joints. It is caused by a twisting motion or hyperextension (forcible) of a joint.

  1. A first-degree/mild grade sprain results from tears in some fibers of the ligament and mild, localized hematoma formation.

    Sign/Symptoms:-
    • Mild pain
    • Edema
    • Local tenderness.


  2. A second-degree/moderate grade sprain involves partial tearing of the ligaments.

    Sign/Symptoms:-
    • Increased edema
    • Tenderness
    • Pain with motion
    • Joint instability
    • Partial loss of normal joint function.


  3. A third-degree/severe grade sprain occurs when a ligament is completely torn or ruptured. A third-degree sprain may also cause an avulsion of the bone.

    Sign/Symptoms
    • Severe pain
    • Increased edema
    • Abnormal joint motion.

DIAGNOSTIC FINDING:-

  • By X-ray
  • Sign and Symptoms

MEDICAL MANAGEMENT:-

  • Apply ice while swelling is present.
  • NSAIDs drug (Analgesics), e.g., Ibuprofen, Diclofenac sodium.
  • Provide rest and comfort to patient.
  • Elevation of extremity to reduce edema.
  • Administer tetanus toxoid if skin integrity is broken.
  • Do warmup and stretching to patient to reduce strain or sprain

NURSING MANAGEMENT:-

  • Apply cold compresses for the first several days (15-20 minutes at a time every few hours).
  • Assess neurovascular status of contused extremity every 1 to 4 hours as patients condition indicates
  • Instruct patient on use of pain medication as prescribed.
  • Educate patient that rest is must for injured part.
  • Teach the patient to avoid excessive exercise of injured part.
  • Teach the patient to resume activities gradually.



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