A crush injury to your hand occurs when your hand is caught between objects that are coming together under a lot of pressure. The damage can be minimal (perhaps just a bit of bruising), or bad enough to involve several broken bones, lacerations, bleeding, and a condition known as “compartment syndrome.” The severity of the injury often depends on how long the hand was between the objects.
Effects of a Crush Injury
A minor crush injury will usually have no lasting effects. For instance, if you slam a finger in a door, most of the time you will be in pain for a day or two, and then you will go about your life and forget about it.
With major crush injuries, there can be damage to the hand well below the skin. If the flow of blood has been cut off for any length of time, tissue damage could result, and the chance of infection will increase. Layers of skin could be removed, further raising he danger of infection. In severe cases, infection can even lead to the need for amputation.
With some crush injuries, compartment syndrome can be a complication. This occurs when the tissues are left without blood for a long period of time. The nerves can become damaged, and muscle tissue can die. Compartment syndrome usually happens in the legs, but it can happen anywhere in the body if the affected part has been trapped for too long. It is rare in the hand, but it can occur. When it sets in, the first symptom is severe pain, followed by a “pins and needles” sensation. Then paralysis sets in, and the hand has no pulse. The skin may appear shiny and swollen.
Treating Crush Injuries
With a minor crush injury, you probably will not require medical attention. If the wound is bleeding, make sure that you clean it. You can elevate the hand, and apply a cold pack to ease the pain. If swelling seems to be excessive, though, or you have little or no mobility, you should see your doctor or go to the hospital emergency room. Most likely the hand will need to be x-rayed in order to determine if there is a fracture. This is important, because fractures can cause compartment syndrome.
If there is moderate to heavy bleeding, you will probably need medical intervention. At the very minimum, you will need a tetanus shot if your immunization is not up to date (a tetanus shot is good for ten years). You may also require antibiotics. It is also important to determine if the injury is severe enough to warrant surgery to ease pressure on the nerves and blood vessels, or to repair broken bones. In some cases, severe crush injuries can require multiple surgeries.
The Final Word
Minor crush injuries may require no treatment at all. Just, as they say, “Walk it off.” However, if the injury is severe, you should seek medical assistant immediately.
For any questions call our Michigan Hand & Wrist Surgery Office at (734) 943-3838 or (248) 485-8300.