“It’s Just a Bruise…Right?” Identification, Management, and Treatment of Osseous Contusions
Dr. Kirk Brumels and Professor Margaret Frens
An osseous contusion, more commonly known as a bone bruise, is caused by a macro-trauma or multiple micro-traumas to the bone. Bone bruises often accompany soft tissue damage associated with joint injury and therefore go unnoticed and untreated since the primary concern is the soft tissue damage. Complications can occur when treatment for the soft tissue injury is ineffective due to the undetected bone bruise. The gold standard test to identify a bone bruise is an MRI, and after one is obtained, there is a better understanding of steps to take in order to treat the entire injury. Bone is highly vascularized and the spongy/trabecular bone is the damaged structure. Subperiosteal hematoma, interosseous bruise, and subchondral bruise are the three different types of bone bruises which differ by the location of the hematoma. Recovery can take anywhere between four months and one year, and pain is often present for the majority of the healing process; this is longer than the recovery time of most soft tissue injuries. Bone bruises commonly occur during an ACL reconstruction, but are not included in the protocol for rehabilitation. Through awareness of osseous contusions, practitioners can have a better understanding of a patient’s pain and necessary recovery time. In this study, a specific case of an osseous contusion is examined and used as an example to present the identification process, treatment options, and management decisions.
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