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