Crush injuries

March 2018 | by EMauthor

•Crush injuries to the hand can result from various mechanisms such as a roll over the hand or heavy objects dropped over the hand

•There may or may not be associated fractures

•There is usually significant soft tissue damage

•The skin and subcutaneous fat may be sheared off the underlying tissues with loss of blood supply to skin

•There may be swelling in sub-fascial compartments of the palm or fingers resulting in compartment syndrome

Recognition

•History of significant crushing mechanism

•Excessive mobility of skin

•Poor circulation, dusky colouration, poor bleeding from wounds or on pinprick

•Crepitus under skin

•Poor capillary refill

•Evidence of compartment syndrome such as excessive pain, parasthesia at the finger tips, or pain on stretching tendons

Management

All these cases should be referred to the orthopaedic team on call

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