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После удара твердым предметом ,на пальце образовалась мягкая шишка, потом стала твердеть и вскоре окостенела , теперь реагирует на погоду и доставляет эстетические неудобства. Как избавиться ? Хирургически только ?
Лучше показаться специалисту, как правило хирургу. Подобные изменения после травмы бывают довольно часто, лечение, как правило требуется только когда данные образования ограничивают движения кисти или вызывают боль.
При ударе твердым предметом или при ушибе в мягких тканях происходит разрыв кровеносных сосудов и излияние крови в них ( ткани ).
В процессе заживления возможны видоизменения структуры мягких тканей , когда происходит образование — " нароста " , шишкообразной опухоли под кожей .
Человек , желая избавиться от " шишки начинает массажировать ее или делать примочки , чем только усугубляет проблему — опухоль от этого не проходит , а начинает затвердевать , переплетаясь с неповрежденными тканями .
Так как пальцы постоянно участвуют в огромном количестве движений за сутки и несут на себе большую нагрузку в плане выполняемой работы в течении дня , то шишка на пальце постоянно задевается и дополнительно травмируется , т. е — в организме постоянно идет воспалительный процесс , поэтому очень скоро нарост начинает реагировать на изменения погоды .
Затягивая избавление от шишки , человек подвергает себя опасности развития злокачественной опухали на месте нароста , так как раковые клетки чаще всего развиваются именно в неблагополучном изначально , органе или части тела .
Необходим обратиться по месту жительства в поликлинику и записаться на прием к хирургу , где вам проведут обследование путем пальпации ( ощупывания ) и назначат сделать рентгеновский снимок нароста .
После ознакомления хирурга с вашим снимком , ему станет ясна структура шишки и
ее место прикрепления и на основании этого вам будет сделано оперативное вмешательство , с целью удаления опухоли .
Такая операция производится под местным обезболиванием , т.е укол с анестезией делают в место , где будет производиться оперативное вмешательство — операция .
Сама операция длится не дольше часа , а обычно 30-40 минут , после чего вас подержат несколько часов под наблюдением в палате , сделают необходимые процедуры и выпишут домой .
Вырезанную опухоль ( шишку ) обязательно отправят на дополнительные исследования , с целью выявить — является ли она злокачественной ( раковой ) или доброкачественной . Результаты будут получены в течении 10 дней и вам сообщат результат и если опухоль окажется злокачественной , вам нужно будет пройти обследование на выявление возможных очагов поражения в организме , чтобы во время начать лечение .
Швы на пальце после операции заживают быстро и как правило , через 10 дней вам их снимут , шрам некоторое время будет красноватым , но специальные рассасывающие крема ( Контратубокс ) исправят этот косметический дефект .
Затягивать с удалением шишки нельзя — сама она не рассосется , так как имеет в своей структуре волокна , которые не могут растворится от наружных примочек , тем более , что есть опасность онкологического осложнения и рисковать не стоит тем паче.
Такую операцию мне самой провели 5 лет назад , а пыталась я " вылечить" нарост народными средствами столько же — 5 лет .
Затягивание с операцией у женщин вызвано еще и тем , что по их рассуждению , некому будет делать обычные домашние дела , поверьте — очень быстро приспосабливаешься с торчащим пальцем всё делать ). И через 2 дня скорость приготовления пищи или уборки не ниже , чем до операции .
Я потом еще долго по привычке палец оттопыривала — берегла , даже когда сняли швы , боялась стукнуть его .
Болевые ощущения полностью отсутствуют , если бы не маленькая белая полосочка ( шрам ) , то вообще можно было бы забыть о наросте .
Обычно после ударов или ушибов на коже появляется простой синяк, который проходит в течение недели. Но что делать, если под кожей образовалась шишка после ушиба, которая не уменьшается и вызывает болевые ощущения?
Степени тяжести уплотнений под кожей
Для начала нужно ясно понимать механизм развития подобных явлений. Выделяют три степени тяжести для последствий ушибов:
- уплотнение образуется в течение дня и почти не болезненное (только при прикосновении);
- ушибленное место немного опухает, появляется постоянная боль, которая нарушает общее самочувствие;
- обширная разлитая гематома, уплотнение в тканях после ушиба резко болезненно, особенно при прикосновении, может повыситься температура тела.
В каких случаях необходимо обратиться в больницу
На любой из вышеперечисленных стадий необходимо проконсультироваться у врача. Но если при первых двух можно проходить лечение амбулаторно, то третья – абсолютное показание для стационара.
Также есть ряд тревожных симптомов, которые требуют более детального осмотра в условиях стационара:
- если долго не проходит уплотнение, необходимо подробно его обследовать, даже при отсутствии болевых ощущений. Желательно сделать это максимально быстро, но оптимальный срок – до 6 месяцев.
- резкая боль, усиливающаяся при пальпации;
- яркое выраженное покраснение кожи над уплотнением;
- повышение температуры тела;
- снижение или потеря чувствительности в ушибленной области.
Хирургические методы лечения уплотнений после ушиба
Хирургическое лечение подобных уплотнений сводится к вскрытию уплотнения и дренированию образовавшейся полости под местной анестезией. Выбор доступа – на усмотрение хирурга. Это может быть простая пункция либо разрезы в одном или нескольких местах. Например, если не проходит шишка на колене после ушиба, то ее устранять могут как одним способом, так и другим (окончательное решение принимается после выполнения всех необходимых диагностических процедур).
После вскрытия хирург очищает образовавшуюся полость от содержимого и при необходимости устанавливает временный дренаж, по которому в течение нескольких дней из раны будет выходить то, что убрать не удалось.
Лекарственные препараты для лечения уплотнения под кожей
Часто задаваемый вопрос – “Чем лечить шишку после ушиба без хирургического вмешательства?”. Если такой вариант возможен и помощь хирурга действительно не нужна, то эффективными могут быть некоторые медикаментозные средства. Однако их использование все равно лучше согласовать с врачом.
Хороший эффект дают аппликации с раствором димексида, разведенным водой в соотношении 1:4 – 1:2. Димексид снимает боль и воспаление, а также уменьшает отек. Есть еще одно полезное свойство этого раствора – он помогает другим веществам (НПВС, гормоны, антибиотики) проникать глубже в ткани организма, тем самым усиливая их эффект.
Можно применить на пораженную область мазь для рассасывания шишек после ушиба. На сегодняшний день их существует огромное количество с разными наименованиями, ценами и самое главное – абсолютно разными медикаментозными эффектами. Поэтому перед применением мази следует проконсультироваться с врачом.
В случае гематомы более эффективным будет применение мази на основе гепарина. Если речь идет о выраженном воспалении, то помогут нестероидные противовоспалительные мази (они также хорошо устраняют болевой синдром) или мазь с гормональным компонентом
В любом случае мазь, рассасывающая уплотнения после ушиба, должна назначаться исходя из механизма формирования самой шишки. А в этом вопросе лучше разобраться вместе с доктором.
Есть еще один хороший способ лечения уплотнений на конечностях, который особенно эффективен при посттравматических гематомах. Поврежденную конечность нужно стараться держать на возвышении, чтобы улучшить отток венозной крови и снять отек. Например, если после ушиба ноги образовалось уплотнение, то под поврежденную ногу на ночь можно положить одну-две подушки.
Для улучшения эффекта врачи иногда рекомендуют бинтовать конечность эластичным бинтом. Такой метод также улучшает микроциркуляцию и помогает снять отечность
Положительный эффект физиопроцедур
Определенные физиопроцедуры могут помочь в лечении ушиба или уже сформировавшегося уплотнения на каждой стадии. В комбинации с применением правильных лекарственных средств желаемого результата можно достичь в более короткие сроки.
Например, если долго не проходит уплотнение на ноге после ушиба, то даже самый простой электрофорез является более эффективной альтернативой вышеописанным аппликациям с димексидом.
Такая физиопроцедура, как УВЧ (лечебное воздействие электромагнитного поля), в лечении подобных шишек будет неэффективной. Её используют при острых воспалительных заболеваниях, а в посттравматическом уплотнении процессы воспаления не происходят. Но на ранней стадии, когда ткани вокруг ушиба воспалены и отечны, электромагнитное поле позволит привести поврежденные ткани в норму гораздо быстрее.
Синусоидальные модулированные токи (СМТ или Амплипульс) показывают хороший эффект при посттравматических уплотнениях. Они также стимулируют трофику в тканях за счет мягкого нейромиостимулирующего действия.
Первоочередное применение этой физиопроцедуры – восстановление атрофированных мышц после травм. Так что в данном случае, СМТ может иметь двойной эффект. Идеально применять этот метод на бедро, голень, плечо или предплечье. Например, если после ушиба икры осталось болезненное уплотнение, то СМТ могут ускорить его рассасывание.
Превентивные методы возникновения уплотнения
Чтобы не образовалась шишка после перелома или ушиба, необходимо в кратчайшие сроки после получения травмы приложить к поврежденному месту холод. Подойдет любой предмет из морозильной камеры. Удерживать 15-20 минут, и если медицинская помощь не требуется, то еще через час.
На этой же стадии актуальным будет и приподнятое положение конечности. Отток венозной крови снизит степень образования отека до минимума. Без отека снижается и вероятность появления уплотнения в дальнейшем.
Бинтовать пораженное место сразу после получения травмы не стоит. В случае недавно полученной травмы такой метод может нарушить трофику тканей и привести к неприятным последствиям
Если нет возможности провести вышеописанные действия, нужно хотя бы оставить поврежденную конечность в покое. Физическая нагрузка в данной ситуации только усугубит клиническую картину и увеличит шанс появления уплотнения в период восстановления.
Заключение
Уплотнения под кожей, возникшие после травмы, требуют особого подхода в лечении. Некоторые можно устранить в домашних условиях, а с другими без хирургической помощи не справиться. В любом случае не нужно стесняться обратиться к врачу с подобной проблемой.
Чем Опасен для Организма Обычный Ушиб? Последствия Травм и Ушибов. Говорит ЭКСПЕРТ: Видео
Закончил Санкт-Петербургский государственный медицинский университет имени академика И.П.Павлова. Работаю терапевтом более 15 лет. Мой девиз в работе и в жизни: "Никогда не говори никогда."
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