UMEM Educational Pearls

Category: Orthopedics

Title: Quadriceps contusion

Keywords: Quadriceps contusion, immobilization, hematoma (PubMed Search)

Posted: 1/23/2022 by Brian Corwell, MD (Updated: 8/17/2022)
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Quadriceps contusion

 

Mechanism:  Blunt trauma from ball, helmet, stick

Usually to the central region

Damage to highly vascular area of the muscle and to local blood vessels can cause hematoma formation

Typical trauma history and pain worse with muscle activation (knee flexion)

Physical exam:  Bruising, tenderness, palpable mass/hematoma

Goals of care: Minimize intramuscular bleeding

Treatment:  NSAIDS, crutches, unique type of immobilization 

Attempt to increase resting length of the quadriceps muscle to facilitate early healing and return to function

  • Immediately immobilize the affected leg in 120°of flexion with an elastic wrap x 24 hr
  • https://img.medscapestatic.com/pi/meds/ckb/18/43218.jpg
  • Frequent icing
  • Followed by early stretching/ROM (Consider referral for formal PT)
  • Continue restricted weight bearing on crutches as needed

 

Note:  Left untreated, large contusions may result in myositis ossificans