UMEM Educational Pearls

Category: Orthopedics

Title: Quadriceps Contusion

Keywords: Muscle injury, splinting (PubMed Search)

Posted: 10/28/2017 by Brian Corwell, MD (Updated: 6/13/2024)
Click here to contact Brian Corwell, MD

Question

Quadriceps Contusion

Mechanism: Blunt trauma to the anterior thigh (frequently football helmet or opponents knee)

Usually involves the anterior quadriceps (rectus femoris and vastus intermedius)

Pain on passive stretch and active contraction

Can develop large hematomas

Loss of knee flexion is a poor prognosticator

Complication: Myositis Ossificans (MO) (5-17%)

               Increased risk with delay in treatment > 3 days

               Radiographs can lag. Ultrasound in more sensitive

               Painful firm area in region of contusion occurring 2 to 3 weeks post injury

http://fifamedicinediploma.com/wp-content/uploads/2015/12/myositis_ossificans_lateral-1.jpg

Prompt treatment….key to good outcome and earlier return to sports

Large hematoma can be aspirated. NSAIDs may reduce edema and risk of MO. Splinting

Place quadriceps in 120 degrees of flexion for 24 hours following injury (keep muscle lengthened)

https://upload.orthobullets.com/topic/3103/images/quad%20contusion_moved.jpg

Answer