Long bone swelling and pain

Introduction Long bone fractures of the extremities are often accompanied by different degrees of swelling, which can lead to pain in the affected limbs, affecting postoperative functional exercise and wound healing. If the swelling is serious, it can directly affect the blood circulation of the limbs, and even serious complications such as compartment syndrome.

Cause

Swelling is a common clinical manifestation in early fractures and fractures. The main reason is due to small blood vessel rupture, hemorrhage and capillary permeability increase, intravascular fluid extravasation into the interstitial space, and muscle reflex sputum due to pain. Such as causing venous return disorders, the blood vessel wall is dilated, permeability increases, resulting in inter-tissue edema. It can also be seen in cases of local trauma or inflammatory infections or irritations such as osteomyelitis.

an examination

Related inspection

Bone and joint soft tissue CT examination bone imaging

Evaluation criteria for swelling degree:

I: Swelling compared to normal skin, but dermatoglyphics still exist.

II: The swelling is more obvious, the skin lines disappear, but there is no bubble.

III: The swelling is obvious, the skin is hard and tight, blisters appear, but there is no compartment syndrome.

The pain was graded using the Digital Pain Classification (NRS) and was classified according to the degree of pain: none (0 points), mild (1 to 3 points), moderate (4 to 6 points), and severe (7 to 10 points).

Differential diagnosis

Subperiosteal hemorrhage or dislocation of the metaphysis of the long bone can cause pain in the affected limb, leading to pseudospasm. One of the early symptoms of infants is that the pain in the limbs is in the pitched frog position. Any movement of the limbs will cause pain and cry, mainly because the joint capsule is full of bloody exudate, so the limbs can only be in the limbs. Flexed state and cannot be straightened. The affected limb is swollen along the long bone and the tenderness is obvious.

Localized bone abscess: mostly occurs in the metaphysis of long bones, local swelling, pain, effective treatment with antibiotics; repeated authors, visible redness and heat pain. X-ray showed that there was a bone destruction zone at the metaphysis, and the edges were relatively neat, and there was generally no periosteal reaction.

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