Hematoma On Leg

A hematoma refers to the abnormal accumulation of leaked blood from damaged blood cells outside the blood vessel. The blood leaks into the neighboring tissues where it does not belong. The blood can accumulate in any part of the body and can be large or small. The damaged blood vessel can be an artery, a vein, capillary or a blood vessel wall.  Hematomas are classified according to its location with the epidural, subdural and intracerebral hematomas being the most dangerous types. Intramuscular hematomas are common in the lower leg and arms and can lead to permanent nerve damage. Other superficial hematomas occur on the ears, fingers and other areas of the body.

In a leg hematoma, the blood collects in the tissues of the lower leg. Hematomas in the leg occur in damaged parts of the leg hindering the blood flow to the affected part. In the case of intramuscular hematomas, the blood supply to the lower leg muscles is compromised and other structures like nerves can be permanently damaged.  This condition is known as compartment syndrome and is usually a complication of fractures. Fractures of the thigh involve hematomas at the fracture site. It is also a surgical emergency and medical care should be accessed immediately if suspected.

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Intramuscular hematomas are very painful due to the high degree of inflammation and swelling.  This condition can also occur in the arms but it is more serious when it occurs in the leg compared to the arms. The elderly are most affected by hematomas due to the weakened tissues and skin.


Complications of a Hematoma

The most common complication of the hematoma is the risk of an infection because the accumulated old blood is optimal for bacteria division.

In localized infection called cellulitis, the infection can spread to the blood stream causing sepsis or septicemia.  It is, however, only common in lower extremities with people whose immunity is compromised, for example,  diabetic patients.

Hematomas are also common problems in deep vein thrombosis whose symptoms are indistinguishable from the appearance of cellulitis.

Symptoms of hematomas include:

  • Swelling in the affected area and the surrounding tissues
  • Pain in the leg that varies in intensity according to severity.
  • Skin discoloration turning a combination of colors such as red, blue-black, yellow and yellow -green.
  • Tenderness and irritation on the affected tissues.
  • Difficulty in walking
  • In the case of infection by cellulitis, other imminent symptoms are warmth in the area of injury and fever.
  • When cellulitis spreads in the blood stream, symptoms of sepsis are elevated heart and breathing rate, fever, a decrease in the urine output, mental problems, and abdominal pain. If it progresses to shock, multiple organs fail causing death.


Causes Of Leg Hematomas

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Trauma: Hematomas are often caused by trauma which can be anything from a fall to an unexpected twist of the legs. Predominantly, the cause of leg hematoma is a direct jolt or blow with a blunt object and falling on hard surfaces.

Risk factors associated with hematoma of legs include:

  • Contact sports like football or kickboxing
  • Blood disorders like hemophilia
  • Using anticoagulant medicines or blood thinners
  • Malnutrition
  • Age
  • Varicose veins
  • Fractures in the pelvis or legs
  • Pregnancy



Physical examination often diagnoses hematomas of the skin and soft tissues such muscle and joints.

Patients that show signs of internal bleeding are taken for imaging tests to evaluate the cause. X-rays are used to access bone fracture while CT scans evaluate head injuries. During pregnancy, the imaging modalities are the ultrasound and magnetic resonance imaging (MRI).


Treatment Of Leg Hematoma

Smaller hematomas resolve in a few days while bigger and serious hematomas require treatment that may take months to heal.


Treatment methods of leg hematoma include the following:

  • To decrease the swelling of the hematoma, the use of heating pads, heat lamps, ointments, whirlpools, and compresses is recommended.
  • Blood thinners also called anticoagulants are used to suppress the blood’s clotting ability lowering the risks of forming more clots. These medications do not remove existing clots but they prevent clots from growing bigger.
  • Pain relievers like Ibuprofen are also prescribed to reduce discomfort.
  • Antibiotics are recommended in the case of infections.
  • Surgical drainage is required for the treatment of large hematoma.
  • Surgery may also be required in the case of hematomas developing over the shin bone.
  • Vena cava filters and compression stockings control blood flow to the leg.
  • Thrombolytic medications are also administered intravenously to patients with life-threatening clots.
  • Natural ways to deal with leg hematomas
  • Taking milk with a pinch of turmeric helps decrease hematoma and prevents infection because of turmeric’s antibacterial and antiseptic qualities.
  • Arnica and comfrey are herbal solutions that reduce the swelling and pain of a leg hematoma.
  • Eating a diet rich in proteins and vitamin C also accelerates the healing process.

Preventing leg hematoma

First aid prevents the onset of hematoma. It should follow the rice method i.e.

  • Rest to stop the flow of blood to the affected area.
  • Ice packs can be applied to the affected area to ease pain and curb bleeding. The ice wrap is placed at least four times a day for twenty minutes.
  • Compression using an elastic bacteriostatic adhesive bandage helps prevent swelling.
  • Elevation makes blood to flow in the reverse direction of the affected area avoiding the risk of the blood accumulating on the affected site.
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