A closed soft tissue injury is an injury to the tissues beneath the skin where the skin or mucous membrane remains intact. The extent of damage may not be readily visible. Swelling, bruising, immobility and pain at the injury site may indicate a closed injury.
When assessing trauma, you should always suspect injury to soft tissues and organs beneath the area of impact or observable surface injuries. For example, a baseball bat to the abdomen may cause a bruise over the umbilicus, but this mechanism might also damage the underlying organs such as the stomach, bowel, pancreas, spleen or liver.
There are six types of closed soft tissue injuries. They are:
Injury to soft tissues from blunt force leads to swelling and edema. Edema is the medical term for swelling as a result of fluid in the skin or muscle. If the swelling becomes great enough it may put pressure on blood vessels and nerves.
Edema is more likely to occur in the lower legs because there isn’t much room for the muscles to swell. The muscles in the lower legs are covered by fibrous tissue called fascia that are not very elastic.
Photo images used with permission of Jones and Bartlett Publishers, Sudbury, MA, www.jbpub.com (Academy of Orthopaedic Surgeons, Trauma Slide Set, Copyright 2002).
