Hematoma Treatment .com

What is a hematoma in the leg?

Hematoma in the leg is a pocket of blood that accumulates in the soft tissues of the lower leg, such as in the enclosed space over the tibia (shinbone/shankbone) and in the tibial plateau below the knee. Due to bigger blood vessels and stress from upper parts of the body, hematoma in the leg is typically worse than one in the arm. As with other types of hematoma, the occurence of leg hematoma is more frequent in the elderly because of their fragile skin and tissue. In this age group, even a seemingly mild injury can create a disproportionately large hematoma.

Signs and symptoms of hematoma in the leg

Occurs following an injury, symptoms of a leg hematoma are related to the injury, which include:

• Leg pain
• Fluctuant swelling over the injured site. Bleeding into the muscular space causes the surrounding tissue to bulge outward.
• Tenderness of the tissues in the affected area. Contusions (bruises) are usually found when the underlying muscle fibers and connective tissue have been broken during the injury.
• Discoloration that progresses through several color changes; from black-blue, green-yellow and yellow, before it completely dissolves.

Causes of hematoma in the leg

The main causes of hematoma in the leg are direct blow with a blunt object and severe fall onto a hard surface. The risk increases with contact sports involving lower legs, such as football and kickboxing, medical history of bleeding disorder such as hemophilia, malnutrition and the use of blood thinner/anticoagulant medications.

How to treat a hematoma in the leg

In the absence of infection, a small-sized leg hematoma gradually dissipates and resolves on its own within several weeks. However, larger-sized hematomas, expanding hematomas, hematomas that are threatening to cause or are causing a compartment syndrome, need to be removed surgically. (Compartment syndrome is a condition when pressure within the muscles builds to dangerous levels, preventing oxygen and nourishment from reaching nerve and muscle cells). Complete healing from such hematomas may take several months.

First Aid

In the event of acute injury, follow the standard RICE instructions for first aid below:

• Rest. Stop your activity immediately after the injury because moving forces more blood into the damaged area. Rest your leg as much as possible so that the muscles can heal faster.
• Ice. Apply an ice pack to stem the bleeding and therefore reduce the size of potential hematoma. Wrap ice chips or cubes in a towel or elastic bag. Place it over the injured area for 20 minutes at a time. Do not apply the ice directly to the skin.
• Compression. To prevent swelling, wrap the injured area with an elastic bacteriostatic adhesive bandage. Make sure the wrap is snug, but not so tight as to cut off circulation.
• Elevation. Raise the injured leg above your heart so that the blood flows away from the site of injury. Do not wrap the leg because this will increase the pressure and aggravate the condition.

Continuing care

The hematoma requires protection and maintenance while allowing for its complete removal.

• During the first 48 hours after injury (acute phase), you will need to continue using rest, ice, compression bandages, and elevation of the injured area to control bleeding, swelling, and pain.
• After 48 hours, use warm towels, heat lamps, heating pads, heat ointments or a hot water bottle and apply it firmly to the injured area every 15 to 20 minutes. This will have a soothing effect and reduce the pain.
• Don’t massage the injured spot as it may restart bleeding.
• Take physiotherapy and rehabilitation exercises when supportive wrapping is no longer needed. Ask your doctor if exercising with low-impact activities is acceptable as long as symptoms do not return.

Diet

Increase your intake of Vitamin C and Vitamin K to improve your immunity and your body’s ability to heal. Equally important, eat a well-balanced diet that includes extra protein, such as meat, chicken, fish, cheese, milk and eggs.

Medications

• Take nonsteroidal anti-inflammatory drugs such as acetaminophen (tylenol), ibuprofen or naproxen for the inflammation and the pain. Don’t take aspirin as it may promote bleeding.
• Your doctor may prescribe stronger pain-killers, if needed. Antibiotics are also given when you develop systemic or local signs of infection, such as headache, muscle aches, fever, chills, increasing swelling and redness.

Prognosis

Prognosis of a leg hematoma is variable, depending on the severity of the injury and the resultant size and location of the hematoma. Complete healing is possible for small hematomas. In larger hematomas, there may be long-term, permanent effects, such as:

• Muscle atrophy and a weak foot due to permanent damage to muscle and nerves, if treatment is delayed.
• Calcification of the blood remaining in the hematoma, if the blood is not completely drained or absorbed, this may result in a permanent hard lump.