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crush injury

Alternative Names 
crush wound

Definition
A crush injury occurs when a body part is caught between 2 objects.

What are the signs and symptoms of the injury? 
Signs and symptoms of a crush injury include:
  • swelling
  • bleeding
  • pain
  • damaged skin
  • numbness
  • a deformed or "mangled" body part
What are the causes and risks of the injury? 
Most crush injuries are the results of accidents. A minor crush injury is often not serious. An example of a minor crush injury is getting a finger caught in a door. A crush injury is more serious when it involves a large force, such as a foot being run over by a car. This type of crush injury may damage tissues below the skin, such as blood vessels, nerves, muscles, or bones. The force may cause the skin to crack or scrape off during the injury. A loss of function or blood flow may occur in the area. The tissue damaged by a crush injury is also at increased risk for infection. There may be permanent numbness or deformity of the injured body part. Amputation, or removal of a body part with surgery, may be needed in severe injuries.

What can be done to prevent the injury? 
Some crush injuries can be avoided with careful use of tools and vehicles. People should not drive or use heavy equipment when they are tired or have been using alcohol or illegal drugs. The National Occupational Health and Safety Commission (NOHSC), is a government organisation which works to create a safer environment in work places where many crush injuries occur. The NOHSC website is; www.NOHSC.gov.au

How is the injury recognised? 
A crush injury is recognised based on:
  • a history of trauma
  • swelling of the affected limb
  • bleeding
  • damage to surrounding tissues
  • pain
  • blood collecting under the skin
  • loss of sensation
X-rays may be taken to help diagnose the injury.

What are the treatments for the injury? 
Minor crush injuries can usually be treated at home. Medical treatment is needed for a more serious crush injury. This treatment is needed to prevent loss of function, restore circulation to the injured area, and prevent infection.

The crush injury is cleansed with soap and water. If there is bleeding, pressure is applied to control the bleeding. Ice is applied. An x-ray is required to determine if the bone was damaged. A tetanus injection should be given if the person has not had one in the past 10 years. Antibiotics may be given to prevent infection. A severe injury may need surgery and even removal of the body part.

What are the side effects of the treatments? 
A tetanus injection may cause pain at the site of the injection. Antibiotics may cause stomach upset, diarrhoea, or an allergic reaction. Surgery has a risk of bleeding, infection, and reactions to the anaesthesia medication.

What happens after treatment for the injury? 
It is important to watch closely for swelling, which is a common problem after a crush injury. Severe swelling can lead to injury of underlying tissue. The affected area should be kept elevated above the level of the heart.

Author: 
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request
 


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