Chest contusion

Synonyms

  • Torso contusion
  • Medical: Commotio thoracis

Introduction

A chest contusion results in an injury to the ribcage, which usually occurs as a result of blunt force (e.g. falling on the ribcage) typically in household accidents or sports accidents. The bony structures of the ribcage, i.e. the ribs, the sternum and the thoracic spine, remain uninjured. The organs protected by the thorax (heart and lungs) are also not damaged by the violent impact.

Causes

Blunt force trauma, such as for example, can lead to a contusion of the chest. A chest contusion can also be a partial occurrence of a multiple injury (polytrauma), but in this case it plays a minor role. – Traffic accidents,

  • Domestic accidents,
  • Sports accidents,
  • And as a result of a severe cough in case of a respiratory infection

Symptoms

In burst basket contusions, there are often no external injuries visible at the beginning, but in the course of time bruising marks, i.e. visible injuries to the skin or underlying soft tissue, such as bruises, can develop. A chest contusion is usually very painful. Patients often complain of pressure pain in the affected area, as well as pain during certain movements.

The pain is particularly acute when breathing. This can cause the patient to adopt a relieving posture, which results in gentle breathing, whereby the lungs no longer develop properly. Pain therapy is extremely important in this case, as bacteria can multiply in the lungs during long periods of gentle breathing with reduced respiration, also known as hypoventilation, and thus pneumonia can develop more easily.

The pain is described as very strong and since the healing of a chest contusion can take months, the pain can also be present for months. As mentioned above, a thoracic contusion usually causes severe pain and, in a large number of cases, also a typical pain-induced shortness of breath, which, in the case of a severe contusion, can cause a so-called cyanosis, the blue discoloration of the skin and mucous membranes caused by a lack of oxygen. Pain occurs mainly when breathing, coughing, laughing and sneezing, but can also occur when bending the upper body and moving the upper extremity.

In addition, difficulties in falling and staying asleep caused by painful chest compression, which often occurs when lying down, have been described as particularly stressful. In the course of a thorax contusion, painful muscle cramps of the intercostal muscles and back pain due to the pain-related relieving posture of the upper body can also occur. Due to the pronounced pain symptoms, one should not wait too long before going to the doctor.

A sufficient pain medication is indicated in most cases. It can sometimes take several weeks before the patient is completely free of symptoms after a chest contusion. The duration of the illness depends on the type and severity of the injury as well as on the personal fitness and training condition of the injured person.

Athletes recover faster after a chest contusion than older people with a weak constitution. The acute symptoms directly after the injury usually last for about one to two weeks. During this time, a pronounced feeling of illness may prevail, but this can be alleviated by adequate pain therapy.

Even after the acute phase is over, many patients still complain of pain. This condition can last for several weeks, in exceptional cases months. As described above, the duration depends on the injury itself and on the physical condition of the injured person.

The healing process of a chest contusion depends on various factors. These include the general state of health and fitness of the person affected, the type and severity of the contusion and compliance with the recommended therapeutic measures. In the best case, a chest contusion can be healed after a few weeks (approx.

3-4 weeks). The duration of the sick leave should also be based on this period. The type of work involved should be considered individually.

Physically demanding jobs, in comparison to office work, may only be carried out again at a later date, as the physical protection of the rib cage is an essential prerequisite for the healing process. Accordingly, it is at the discretion of the patient and the treated family doctor how long the exact duration of the sick leave will be. Depending on the patient and the cause, a chest contusion can be present to varying degrees.

The specific anatomical characteristics of the respective patient also have a decisive influence on the duration of healing of the chest contusion. In addition, the time of diagnosis and the type and intensity of the treatment initiated are of enormous importance. As a rule, not only a single rib, but several ribs are affected in the course of a trauma.

For this reason, the time required for a chest contusion to heal completely varies from case to case. In the ideal case, i.e. when a single rib is affected, the diagnosis is made promptly and the affected ribs are sufficiently immobilised, the time required for complete healing of a chest contusion is approximately three to four weeks. However, in cases of severe trauma and/or severe impairment of the affected rib, the healing process may take several months.

Especially in the case of a thoracic contusion caused by a respiratory infection, i.e. a severe cough, the healing time can be greatly extended. The reason for this is that a real immobilization of the thorax cannot be guaranteed by a persistent cough. Thus, despite the already existing chest contusion, the cartilage-bone apparatus continues to be overloaded and high pressures are exerted on the damaged ribs.

A real healing can therefore only begin after the cough has subsided. In addition, a chest contusion caused by a severe cough is in most cases diagnosed very late. The reason for this is the fact that patients suffering from a respiratory infection and severe cough do not immediately consult a doctor when cough-related pain occurs.

Furthermore, many doctors attribute pain phenomena in coughs mainly to an overstrain of the muscles and/or diaphragm. Direct treatment of chest bruising is therefore usually initiated very late in these patients. For this reason, the time until healing is prolonged enormously.