Crush Injuries

A crush injury to the foot is a traumatic occurrence caused by the compression of the foot between two hard surfaces leading to severe bone and soft tissue injury. Crush injuries can occur from auto accidents, heavy objects falling on the feet, or machinery running over a foot. Crush injuries can occur on the job when heavy machinery is being used or in natural disasters such as earthquakes.

Damage to the foot from a crush injury can include lacerations, bruising, fractures, bleeding and nerve damage. It is important to seek medical attention immediately after a crush injury due to the high risk of necrosis, death of tissue, from compromised blood supply to the area. Another common risk of crush injuries is compartment syndrome. This is a dangerous condition that occurs when pressure inside the tissues is higher than the blood pressure of the vessels supplying nutrients to the tissues. This condition leads to diminished healing from decreased nutrients and can lead to necrosis, death of the tissues. Symptoms include pain and swelling in the leg, numbness and tingling, skin color changes to the leg, and coldness to the leg and/or foot. Call your surgeon immediately should you experience these symptoms. Another serious complication of crush injuries is a condition called Rhabdomyolysis or crush syndrome where the body releases byproducts from the injured tissue into the bloodstream. Rhabdomyolysis can lead to renal failure, irregular heartbeat, disability and even death if not treated timely.

Crush injuries are diagnosed on physical examination and history of the accident. X-rays will be taken to assess for bone fractures and MRI and CT scans are done to assess soft tissue damage. Blood tests are done to assess blood loss and rhabdomyolysis. Treatment of crush injuries depends on the type and extent of the injury but surgery is often the only option.

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© Jessica Gallina MD, Orthopaedic Surgeon - Foot and Ankle , New York, NY
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