A Guide To Treating Crush Injuries

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Here is a view of the surgeon measuring the compartment pressures of the foot in a patient who sustained a bulldozer crush injury.
Two dorsal incisions were used to decompress the adductor and the four interosseous compartments.
The authors used a medial-plantar incision to decompress the medial, lateral, superficial and calcaneal compartments.
This patient sustained an open crush injury to the talus when a railroad beam fell on his foot.
The patient underwent debridement with talectomy and external fixation. A muscle flap was used to cover the soft tissue defect. A tibiocalcaneal arthrodesis will follow.
This patient sustained a Lisfranc’s fracture dislocation with disruption of the midtarsus and an impaction “nutcracker” fracture of the cuboid after being involved in a boating injury.
This injury was open reduced and internally fixated. An external fixation device was used to span the cuboid fracture and maintain length.
This patient sustained a severe crushing injury to the distal tibia and fibula as well as his entire foot. The injury occurred when a 3,000 lb. steel beam fell on his lower leg.
This patient had poor vascular status to his foot. He was temporarily fixated with pins while his foot was closely monitored. He eventually required a below-knee amputation due to the severity of the trauma.
By Zach J. Tankersley, DPM, Robert W. Mendicino, DPM, Alan R. Catanzariti, DPM, and Jordan P. Grossman, DPM

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