The primary causes for foot crush injuries are from heavy falling objects, industrial, motor or railway vehicles rolling over the foot or toes, and crush injuries from industrial manufacturing equipment. There are many varying degrees of injury, depending on such factors as the weight or the crushing force imparted on the foot. The most severe injuries involve tears of the plantar fascia, amputations, partial or complete avulsion of soft tissue and multiple fractures. Another serious complication is the formation of a compartment syndrome in which there is such excess swelling and internal pressure inside the foot that circulation is compromised and nerves are lost.
The initial treatment of a crush injury of the foot usually determines the optimal clinical outcome. Several long term studies have concluded that if specific steps are followed in the immediate medical care of a foot crush injury, the patient will have a better chance for a fuller recovery, even if the damage includes fractures and extensive soft tissue injury. Myerson and Henderson studied workers with mangling-type injuries were followed for an average of over three years after. The researchers found that by following precise protocols 46% had good functional recovery, 29% with "fair" results, and 25% with poor results. It is easy to see that the numbers do not paint a rosy picture for recovery from this type of injury. Crush injuries present a significant challenge in medical care and workers compensation claim management because of the potential for a protracted recovery time.
The immediate care of crush injuries is highly important. After the injured is taken to the emergency room, an investigation into how the injury occurred and for how long the foot was crushed. Next, a physical exam will assess nerve and vascular damage. A procedure called a regional ankle block may be performed to provide some pain relief. If tissue loss or an open wound is present, it is important to start administering antibiotics intravenously immediately. In the event of larger open wounds, amputation or severe tissue destruction, microvascular surgery may be required to fix circulation problems.
At East Ocean Podiatry, we take crush injuries extremely seriously. It is our priority to help you regain as much use of a damaged foot as humanly possible. However, in many cases returning to the level of mobility prior to the injury is impossible. If you want to determine what your treatment options will be, as well as a timetable for recovery, do not hesitate to call and set up an appointment.