ARM CONTUSION, FOREARM |
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DESCRIPTIONAn arm contusion refers to the bruising of the skin and underlying tissues of the forearm caused by a direct blow. Contusions cause bleeding from ruptured small capillaries, allowing blood to infiltrate muscles, tendons, or other soft tissue. The tissues of the forearm, including the blood vessels, muscles, tendons, and nerves, the covering of the bone (the periosteum), and the connective tissue are involved. Appropriate health care includes a doctor's care, unless the child's contusion is quite small; self-care for minor contusions and for serious contusions during rehabilitation; physical therapy for serious contusions.
SIGNS & SYMPTOMS
Forearm swelling--either superficial or deep.
Pain and tenderness in the child's forearm.
Feeling of firmness when pressure is exerted on the injured area.
Discoloration under the child's skin, beginning with redness and progressing to the characteristic "black and blue" bruise.
Restricted forearm activity proportional to the extent of injury.
CAUSES
Direct blow to the forearm, usually from a blunt object.
RISK FACTORS
Violent contact sports, especially when the child's forearm is not adequately protected; medical history of any bleeding disorder such as hemophilia; poor nutrition, including vitamin deficiency; use of anticoagulants or aspirin.
PREVENTING COMPLICATIONS OR RECURRENCEYour child should wear appropriate protective gear and equipment during competition or other athletic activity if there has been a recent contusion or if the activity makes a contusion likely.
BASIC INFORMATION
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor for all except minor injuries; X-rays of the injured area to assess total injury to the soft tissue and to rule out the possibility of underlying fracture. (The total extent of the child's injury may not be apparent for 48 to 72 hours.)
POSSIBLE COMPLICATIONS
Excessive bleeding, leading to disability. Infiltrative-type bleeding can sometimes lead to calcification and impaired function of injured muscles and tendons.
Decreased blood supply to forearm muscles, causing tissue death, loss of function, and contraction of affected muscles.
Prolonged healing time if the child's usual activities are resumed too soon.
Possible infection if the skin is broken over the contusion.
PROBABLE OUTCOME
Healing time varies with the extent of the child's injury, but the average healing time for forearm contusions is 2 to 3 weeks.
TREATMENT
FIRST AIDUse instructions for R.I.C.E., the first letter of rest, ice, compression, and elevation. See Appendix 39 for details.
HOME CARE
Use a sling to immobilize the child's arm.
Wrap an elasticized bandage over a felt pad on the injured area. Keep the area compressed for about 72 hours.
Continue ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage gently over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
Massage gently and often to provide comfort and decrease swelling.
MEDICATION
For minor discomfort use acetaminophen or ibuprofen; topical liniments and ointments.
Your doctor may prescribe stronger medicine for pain.
ACTIVITY
Your child should begin activities slowly and stop exercise as soon as pain begins. The child can increase activity as healing progresses.
DIET & FLUIDS
No restrictions.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of a forearm contusion that doesn't improve within a day or two.
The skin is broken and signs of infection (drainage, increasing pain, fever, headache, muscle aches, dizziness, or a general ill feeling) occur.
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