Musculoskeletal Trauma - Prevention and Management

Introduction

Musculoskeletal injuries are common human injuries due to damage to the bones, tendons, nerves, muscles, ligaments, and blood vessels. It may be caused by repetitive strenuous activity, resulting in complaints, pain, deformities, and complications. Musculoskeletal trauma accounts for a large percentage of work-related injuries. Musculoskeletal injuries may affect multiple parts of the human body and include symptoms like back pain, body aches, numbness, atrophy, tingling, and weakness.

What Is a Musculoskeletal System?

The musculoskeletal system consists of cartilage, bones, tendons, ligaments, and connective tissues. They support human body weight and maintain posture. The potential role of the musculoskeletal system in humans is to facilitate movements and maintain posture. The adult human body contains nearly 600 muscles and 206 bones, connected by tendons, ligaments, and soft tissues.

What Are the Components of the Musculoskeletal System?

The musculoskeletal system is made up of different components, and they are:

• Bones - They support the human body and protect tissues and organs. They work with tendons, muscles, ligaments, and connective tissue to facilitate balanced movement. Bones are the storehouse of calcium, fat, and other minerals and also produce blood cells.

• Joints - Bones unite together to form joints. There are multiple small and large joints in the human body, like the knee joint, ball and socket joint, hinge joint, synovial joint, and pivot joint.

• Cartilage - They cushion the bones inside the joints and help in movement and protection from trauma. Cartilage is a connective tissue in most human bodies, like the ears, nose, lungs, and pelvis.

• Ligaments stabilize the joints and connect bones and are made of tough collagen fibers.

• Muscles - They are made up of numerous fibers. Muscles facilitate movements and day-to-day activities.

• Tendons - They connect muscles to the bones and are made of collagen and fibrous tissue.

What Is Musculoskeletal Trauma?

Musculoskeletal trauma or injuries involving the ligaments and tendons may result in long-standing effects on the individual and reduce the ability to maintain normal physical activities. These injuries are usually very common and result in a significant burden on the medical care system. Musculoskeletal injuries are managed by a team of medical specialties, including emergency medicine, orthopedic surgeons, rheumatologists, and sports medicine. Musculoskeletal injuries affect multiple body parts like muscles, bones, ligaments, joints, tendons, cartilage, and soft tissues. These injuries are associated with mild to moderate symptoms, including body aches, weakness, lower back pain, atrophy, tingling, and numbness. The continuous movement of a musculoskeletal trauma may cause chronic inflammation and permanent disability.

What Are the Different Forms of Musculoskeletal Injuries?

Soft Tissue Injuries - These account for musculoskeletal injuries involving body tissues other than bones. Soft tissue injuries include muscles, skin, tendons, vessels, ligaments, and nerves. Based on the nature of the soft tissue injury, it is again divided into open or closed wounds.

1. Open Wounds - In this type of musculoskeletal trauma, the skin is broken, and the underlying tissues are exposed. It is again divided into different types. They are:

• Lacerations - They are skin cuts with jagged edges.

• Aberrations - In this type of trauma top layer of the skin is injured.

• Punctures are narrow, deep wounds such as a knife or nail stab wound.

• Amputations involve the partial or complete detachment of body parts or limbs due to trauma.

• Avulsions - In this type of injury, the skin flap is forcefully torn from the attachments.

• Incisions - They are injuries that resemble a paper cut with smooth edges.

2. Closed Wounds - In this type of musculoskeletal trauma, the injured site does not connect with the outside surface. Closed wounds can be divided into the following types.

• Contusion- A contusion is characterized by traumatic injuries to the tissues under the skin without breaking the skin.

• Edema consists of fluid collection under the skin from inflammation or trauma.

• Sprain - In this type of musculoskeletal trauma, there will be damage to the ligaments, bone dislocation, or ligament stretching.

• Ecchymosis is characterized by skin discoloration due to trauma and resulting blood loss into the surrounding tissues.

• Strain consists of tearing or stretching the muscles due to trauma.

Fracture and Dislocation Injuries - It comprises musculoskeletal trauma involving the bones and resultant bone dislocation (displacement of bone) and fractures. This type of musculoskeletal trauma can be again divided into multiple types based on the site of involvement. They are:

• Neck and shoulder injury.

• Leg and foot injury.

• Wrist and hand injury.

• Elbow injury.

• Spinal and neck injury.

How Can We Prevent Musculoskeletal Injury?

Prevention of musculoskeletal injuries is essential to maintain the normal structure and function of the musculoskeletal system. The following measures can be implemented to reduce musculoskeletal injuries.

• The early medical intervention of repetitive trauma to prevent permanent trauma.

• Maintaining proper body posture.

• Avoiding abrupt body movements.

• Creating healthy awareness in workplaces to avoid posture injuries.

• Use of protective gear during sports.

• Providing a safe working environment with proper safety precautions.

How Can We Manage Musculoskeletal Injuries?

Different methodologies involving multiple medical specialties are used to manage musculoskeletal injuries. The treatment options depend on the nature of the musculoskeletal injury and its severity. They are:

• Management of basic airway and circulation.

• Intravenous fluids.

• Use of pain-relieving medications.

• Management of soft tissue injuries.

• Splints.

• Immobilization of fractures.

• Steroid injections.

• Repositioning.

• Muscle relaxants.

• Orthopedic surgeries.

• Control hemorrhage.

• Physical therapy.

• Therapeutic massage.

Conclusion

Musculoskeletal trauma accounts for the majority of human injuries in occupational workers. It involves damage to the musculoskeletal systems due to accidental or strenuous activities. Musculoskeletal trauma affects joints, bones, ligaments, cartilage, muscles, tendons, and soft tissues. Musculoskeletal defects can be of different types based on the area affected and associated defects. They are soft tissue injuries, bony fractures, and joint dislocations. Management of musculoskeletal trauma relay on the severity of the injury and underlying defect. Multidisciplinary management involving various medical specialties is involved in treating musculoskeletal trauma to improve outcomes and reduce complications.