CRUSH INJURIES AND AMPUTATIONSTraumatic injuries to the fingers, hand, wrist or arm that result from being crushed either under an object or between two objects are emergencies that require immediate treatment in the hospital. Many crush injuries occur at the workplace with heavy equipment or machinery, but some can be as simple as catching a finger in a door. Commonly, this results in fracture of the tip of the finger and an associated laceration through the nailbed that requires surgical attention.
After being evaluated in the emergency room, a hand surgeon will determine the course of treatment depending on the severity of the injury. Crush injuries sometimes require immediate or urgent surgical intervention for repair of the injured structures. Occupational or physical therapy may be required to assist with recovery.
Amputation of any part of the upper extremity is an emergency that requires immediate treatment in the hospital. While it is always encouraged to attempt to bring the amputated segment to the hospital, it is not always possible to reattach, and an evaluation by a hand surgeon is required to determine if this is possible. Reattachment of an amputated finger, called replantation, can be achieved in some cases. This depends on many factors, including the level of amputation, mechanism of injury, and the patient's overall medical health. In many instances, the amputated site will require a revision amputation surgery to achieve wound healing and prevent infection. More complex reconstructive surgery to restore or improve function or alleviate pain can be performed electively during the recovery stage. Occupational or physical therapy is necessary in most cases of amputation.