Finger bruise – the closed traumatic damage of soft tissues of finger of the top or lower extremity. The trauma usually arises in life as a result of blow. It is shown by puffiness, cyanosis, sharp pain and restriction of movements. At blow in a nail phalanx subnail hematomas are sometimes formed. On clinical symptomatology the bruise of a finger can remind a change therefore at such damages survey of the traumatologist is necessary. For an exception of a change appoint a X-ray analysis. Treatment, as a rule, conservative, in the presence of a large subnail hematoma is shown opening.
The bruise of a finger belongs to the category of small traumatic damages. This trauma is high on the list among the reasons of the appeal to emergency stations. Usually arises in life. Fingers of a hand suffer at blow from a heavy subject (for example, the hammer), work on giving, pinching of a finger between various firm surfaces (for example, between a door and a jamb). Bruises of toes are formed when falling heavy objects on foot or at blows about firm objects (about a chair leg, about a jamb). Perhaps also damage in operating time or sports activities.
Symptoms of a bruise of fingers are similar to symptoms of a fracture therefore for an exception of serious damages at similar injuries it is necessary to see a doctor. In some cases the bruise of a nail phalanx of a finger of a hand is followed by a rupture of a sinew of a razgibatel or his separation from the place of an attachment. At the early address in such cases it is usually possible to do without operation, in the remote period surgical interventions are required that is one more serious argument in favor of visit of the doctor during the first hours after a trauma. Treatment of bruises of a finger is performed by the doctors specializing in the field of traumatology and orthopedics.
Fingers consist of the small tubular bones connected among themselves by mobile joints. The first fingers have two phalanxes, the others – three phalanxes. Bones are surrounded with a cellulose layer, on back and palmar (on foot – plantar) the surfaces of fingers pass the sinews which are attached to nail and average phalanxes. On side surfaces vessels and nerves from which the set of the small branches providing blood supply and an innervation of fingers departs settle down.
Fingers of hands – the high-differentiated body intended by the nature for performance of very exact and difficult movements. It causes rich blood supply and an innervation of fingers. At a bruise small vessels and nerves suffer. Vessels are broken off, blood streams in soft fabrics. Because of hypostasis and hemorrhages the nervous terminations are squeezed that leads to emergence of an intensive pain syndrome. The situation is aggravated with the fact that skin of fingers of hands (especially their palmar surface) dense, a little subject to stretching. Because of it in fabrics sites of high pressure are created that leads to strengthening of pains.
Toes krovosnabzhatsya not so well and innervated, however disteel departments of foot bear on themselves big loading during standing and participate in a leg rift during walking that causes noticeable violation of a support and movements even at small bruises of fingers. Skin of this anatomic zone is even more dense, than on the palmar surface of fingers of hands therefore bruises of fingers of foot are also followed by increase in local pressure, formation of the centers of tension in fabrics and a sdavleniye of the nervous terminations with development of the expressed pain syndrome.
Bruises of fingers of hands
The patient complains of pain in a finger. In the anamnesis the characteristic trauma comes to light: blow in a finger, pinching of a finger between firm objects etc. The finger is edematous, skin cyanotic, sometimes with a crimson shade. Under a nail bed or in the thickness of skin small hematomas can come to light. At subnail hematomas because of formation of a zone of high pressure of pain become more intensive, pulling or holding apart, reminding a pain syndrome at purulent processes.
Palpation is painful. Rough deformation and violation of anatomic ratios is not observed. There is no bone crunch, pathological mobility is absent. The movements are usually limited, but are possible. For a final exception of a change appoint a finger X-ray analysis, in doubtful cases (usually at children of younger age) carry out bone KT. According to additional researches pathological changes from bone structures do not come to light.
Sometimes at blow to a face part of a finger or falling on the straightened finger in a nail phalanx along with a bruise there is a hypodermic rupture of a sinew of a razgibatel which can be full or incomplete. At an incomplete rupture of the movement partially remain, but full extension becomes impossible. At a complete separation because of the bent nail phalanx the finger takes a form of "hammer", the razgibatelny movements are absent. The diagnosis of a rupture of a sinew is exposed on the basis of data of survey.
First aid at bruises of a finger is simple. If on a finger there is a ring, it needs to be removed immediately as because of the accruing hypostasis in the subsequent it will become impossible. It is necessary to put ice to a finger or to set up him under a stream of cold water. Cold water can be used only as means for removal of an acute pain, long is not recommended to wet a finger (for example, to do cold compresses), it will negatively affect skin. To narrow vessels, will help to reduce hemorrhages and to prevent developing of the expressed hypostasis a package of ice.
If in a finger there are small wounds or grazes, they need to be processed iodine or brilliant green. To preventively "cover" all finger, trying to protect it from penetration of an infection, it is not required – it will only complicate survey of the traumatologist. At partial peeling of a nail plate it is necessary to wash out a wound and to apply a bandage to avoid a further travmatization. It is not necessary to fix the torn-off part of a nail plate an adhesive plaster – it increases risk of its separation at removal of a bandage. It is not necessary also to try to open hematomas. After first-aid treatment of the patient bring to emergency station to exclude heavier damages (fractures, dislocations).
Treatment of bruises of a finger is performed on an outpatient basis. Intracutaneous hematomas open, at small subnail hematomas pierce a nail with a needle, producing the accumulated blood. At large subnail hematomas removal of a nail can be required. To the patient recommend not to load a hand, whenever possible to keep it in sublime situation and to put at first cold, and then dry heat. The anesthetizing medicines usually are not required, at severe pain it is possible to accept once analginum, or any other analgetic. The term of disability fluctuates from 1 to 2-3 weeks.
At a hypodermic rupture of a sinew of a razgibatel right after a trauma impose plaster to steak or a special bandage, fixing the straightened finger in a condition of reextension. In certain cases carry out a finger immobilization, keeping an average phalanx in the provision of bending, and nail – in the provision of extension. The term of an immobilization makes 4 weeks. If after this period active extension of a finger remains impossible, expeditious treatment – a sinew seam with the subsequent fixing by Kirchner's spoke or plaster longety is shown.
Bruises of toes
The patient with a bruise of a finger is disturbed by pains in the field of damage. In the anamnesis falling of a heavy subject on foot or blow by a sock about a firm subject comes to light. Right after a trauma a pain syndrome intensive, in the following several hours of pain decrease, and in process of increase of hypostasis amplify again. The finger is increased in volume, is cyanotic. At a bruise of a nail phalanx subnail hematomas often come to light. The movements are limited, at a support the patient tries to step on a heel, without loading forward departments of foot. On a X-ray analysis of fingers of foot and KT of foot lack of changes comes to light.
At a stage of first aid the same events are held, as at a hand finger bruise: cold, sublime position of an extremity, processing of grazes brilliant green or iodine. It is necessary to consider that small wounds standing suppurate more often than on hands therefore the finger needs to be washed out carefully under a water stream to remove pollution from area of grazes. Independently it is not necessary to open hematomas. As well as at a hand finger bruise, it is necessary to address right after a trauma the traumatologist for an exception of more serious damages.
Treatment out-patient in emergency station. Hypodermic and subnail hematomas open, at large subnail hematomas delete a nail plate and apply an aseptic bandage. At slight injuries recommend to push less around and to keep sublime position of an extremity. At heavy bruises of several fingers in some cases impose plaster to provide rest of the struck segment. At sharp pains recommend to accept analgetics. The patient is directed to UVCh. Disability term usually makes 1-3 weeks.