With the advent of MRI, we now have a new category of bone injury called a bone contusion (also called bone swelling). Is a bone contusion really a fracture? I think so, but thus far, we don’t really have the vocabulary in the literature to call a bone contusion a fracture. Let me explain…
A contusion is a term usually applied to soft tissue injuries that involve numerous structures. A contusion may involve nerve, subcutaneous tissue, tendon, etc. When we use the term contusion and refer to a bone injury, we’re describing a crush injury to the bone. Bone is usually made of a hard, outer surface with a softer, spongy inner surface. That softer, spongy surface acts as a shock absorber, absorbing load. But with a contusion, the hard, outer bone and the softer inner bone is crushed.
This is a hard injury for the bone to heal. And often, a hard choice for surgeons to try to rebuild. We drill it, graft it. But in most cases, the idea is to restore the bone to its normal load-bearing structure.
So is a bone contusion really a fracture? I think so. Any thoughts?
Jeffrey A. Oster, DPM