Bruised tibia

introduction

The shin is called in medical parlance Tibia designated. This is a long tubular bone of the lower leg. Another bone of the lower leg is the fibula (lat. Fibula), which is, however, somewhat narrower than the shin and lies on the outside (lateral) of the tibia. At the proximal end of the tibia, i.e. at the end of the bone further towards the center of the body, there is a so-called tibial plateau (Latin: tibial plateau). This represents the starting point for important structures of the knee joint, namely the cruciate ligaments and the menisci. In addition, the shinbone is connected to the thighbone (lat. Femur) connected so that it is involved in the formation of the knee joint. Since it is a long bone, the shin has a long shaft. On the one hand, there is the prominent point where you get a bruised shinbone, and on the other hand there are also some origins and attachment points for muscles of the lower extremity. The distal part of the bone of the tibia, which is further away from the middle of the body, is involved in the formation of the upper ankle joint.

As bruise is a lesion that has a swelling and Bruising due to external violence. In medical jargon, the bruise is also known as Contusion (lat. contusio).
The bruise can various organs concern so that one between muscle-, joint-or Bruised bone differs. In our case of the bruised shin it is of course a bone contusion. The various bruises have in common that they result in edema formation lymphatic fluid and Blood leak from the smallest Blood vessels (Capillaries) accompanied.

Sites predisposed to bruise are generally places where bony structures are relatively superficial. Therefore, the tibia is a typical place of manifestation of a tibia contusion. As everyone knows from personal experience, there is only a thin layer of skin over the shin. The easily palpable bone part of the shin that lies under the skin is called the "Margo anterior", a front bone edge. This is a point of bone that separates the middle and side bone surfaces of the tibia. The shaft has a total of 3 bone sides: a middle, a side and a back side. The area between the bone edge and the skin is so thin that there is hardly any fat or muscle tissue that could act as a buffer or shock absorber to protect against a bruised shin. The fact that the thin skin is very well innervated also makes a bruised shin a very painful event.

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causes

Reasons for a bruised shinbone are very straightforward. You usually pull one Bruised bone on the shin by stretching the shin strikes or kicks against a rigid or solid object that cannot yield. Also a Fall on the shin can become one bruise to lead.You can go through between bruises in the shin external force differentiate that is your own fault, i.e. when you bump yourself or fall, or that is caused by someone else if you get a kick in the shin. Therefore, such an injury can occur both in everyday life and during sports activities. Team sports with a focus on duels how Soccer or hockey are considered particularly risky sports with regard to a bruised shinbone. As mentioned earlier, this is Shin little protected and due to the lack of cushioning by fat–Or muscle tissue very vulnerable for a bruise.

Symptoms

The classic symptoms of a bruised tibia are pain, swelling, a bruise and a certain Restriction of movement.

Because the thin skin very good above the shin innervated is, lies one high sensitivity to pain in front. With a bruised shin it comes to a immediate, severe pain. The pain intensity can be increased by pressure or strain or movement. Fortunately, the initially very severe pain subsides relatively quickly.

Swelling of the affected tibia will soon occur. The reason for this is the fact that when the bruise occurs, the tissue types involved are compressed against each other. The softer tissue, i.e. the skin, is pressed so strongly against the hard bone that the squeezing causes blood and lymph to escape into the surrounding tissue, as already explained at the beginning. The spread of the two liquids can then be perceived optically as a swelling or dent on the shin. The dent is so obvious that there is no masking muscle or fat layer.

In addition, a hematoma, i.e. a bruise, forms between the skin and bones because of the leaked blood. The typical discoloration remains a little longer; usually several days, so that after the swelling has subsided, the shin still shimmers bluish to purple at the bruise site. In some cases, a bruised shin bone also leads to slight restrictions in movement. However, this symptom is more common with joint or muscle contusions.

You may also be interested in this topic: Lump on the shin

Diagnosis

In most cases, bruised tibia is a visual diagnosis. The typical symptoms like swelling and bruise are relatively easy to define. It is then important that the doctor give a detailed Anamnesis interview leads so he can get an overview of the the accident gets. Thus, the doctor can exclude possible differential diagnosis or even consider it. The typical one Pain character - First very strong, but then soon subsiding pain - should also be asked. Then the physical examination which includes palpation of the affected tibia. It is important to pay attention to whether there are any indications of a Broken bone of Shin gives. Fraktur signthat would be groundbreaking are those Step formation, abnormal mobility and the Crepitations. The exclusion of an involved bone fracture is essential, as this is the most important differential diagnosis of tibial contusion.

If you are unsure whether the symptoms are actually due to a Bruised tibia based and there may not be a fracture of the tibia, a X-ray examination to show the bony structures. If necessary, a Ultrasound examination be made. However, the ultrasound is more important for muscle and joint contusions, because it is more likely Tendons and Tapes can be damaged, which can be visualized by ultrasound.

therapy

The tibia contusion is a harmless and relative uncomplicated injury. Therefore, it is usually not necessary to see a doctor. The tibia contusion can be resolved with the PECH rule self-therapy very well. The primary goals of this immediate measure are pain relief and swelling reduction.

"P" stands for Break and means that the shin immediately immobilized shall be. If it continues to be stressed, the exertion reflexively increases blood flow. The increase in blood flow would then increase the risk of vascular lesions and persistence of the symptoms or aggravation. Generally should at least No stress on the shin for 2 days become. Nevertheless, you shouldn't take too long a break, after 14 days at the latest, the affected region on the shin should be loaded normally again.

In addition to pausing, this is Cool of the bruise essence ("E" for ice). You should not bring the ice into direct skin contact, but place a cloth or something similar between the ice source and the skin.

Furthermore, the point must be compressed ("C" for compression) to relieve the swelling. The compression by applying a tight bandage can be done in combination with cooling by wrapping an ice pack between the bandage loops.

Ultimately, you should still have the leg elevate („H "for high camps). Among other things, this promotes the removal of the lymphwhich got into the surrounding tissue through the bruise. All aspects of the PECH rule must timely as otherwise they would be of little help and ineffective for the treatment of a bruised shin. To reduce the extent of the swelling, it is essential to act quickly. With regard to the lymphatic fluid, some doctors also advise Lymphatic drainage. About that no heat therapy or ointments that promote blood circulation should be applied, however, there is agreement.

For drug therapy there is the possibility of pain relieving ointments or sports gel to be applied to the bruised area for cooling. The very well-known and proven phytopharmaceuticals from the field of Naturopathy: the so-called "Comfrey“ (Symphytum officinale). In addition to the bruise, the sprain or strain is an indication for using the comfrey ointment. Their effect includes the local irritation reduction, the Wound healing promotion and the property anti-inflammatory (anti-inflammatory) and decongestant To have effects.

As long as there is no suspicion of a fracture, conservative treatment is sufficient. However, if there are persistent symptoms or if it hardens Suspected one Tibia fracture, an invasive approach may need to be followed. One of them is the operative intervention but also already the Puncture of the swelling or bruise. In the case of a severe effusion, this must be opened and cleared and then even supplied via a drainage system in order to remove the remaining secretion (lymph and or blood) to convey out.