⚠️ Case of a work realted injury, where a crane malfunctioned, dropping a concrete block on a mans foot, causing a severe crush injury with complete skin avulsion.
The outcome of this accident is not known, but based on the extent of the injury, amputation was probably the only option. Crush injuries of the foot can present with complex, difficult to manage deformities and fractures. These are serious injuries with the potential for amputation. Initiate tetanus prophylaxis if necessary. Pay special attention to the neurovascular status and soft tissue envelope. Closely monitor any contusions, abrasions, lacerations or degloving for signs of necrosis. Furthermore, if the patient is able to relate a detailed history of the incident, it can provide valuable insight into the mechanism and extent of injury. With crush injuries, the damage is often much worse than is immediately apparent. Thus, understanding the zone of injury that exists beyond the initial injury site is crical. This is an area of soft tissue and/or bone that was not directly impacted, but succumbs to pathologic changes. In a crush type injury, soft tissue and skin necrosis may extend well beyond the area of impact. This becomes important in surgical planning as it is easy to underestimate the extent of the damage. Case credit @Medicalpedia
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