Multiple hand fractures - crush injury

Case contributed by Dr Derek Smith

Presentation

Left hand crushed by boulder. Open wounds to dorsum over MCPJs and index PIPJ.

Patient Data

Age: Adult
Gender: Female

Comminuted fractures of left index, middle and ring finger proximal phalanxes. Index finger fracture has significant volar angulation. Minimally displaced longitudinal fracture of middle phalanx of third digit. No articular involvement.

No other bony injuries.

Significant soft tissue swelling. No radioopaque foreign bodies.

Case Discussion

This patient has had a signficant crush injury to the left hand. IV antibiotics, washout, immobilsation and elevation are initial measures that can be taken. Assessment of the neurovascular status of the affected digits and any obvious tendon involvement should be documented. Further management should be with orthopaedics or specialist hand centres (this case involved decompression of the carpal tunnel and K-wire fixation of the proximal phalangeal fractures).

PlayAdd to Share

Case information

rID: 36663
Case created: 4th May 2015
Last edited: 30th Jun 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.