Crush Injury
A crush injury of the hand is a way of injuring the hand that can damage important structures such as bone, ligaments, blood vessels and nerves. Physiotherapy is a beneficial treatment following a crush injury to the hand.
What can cause a crush injury of the hand?
Crush injuries are usually caused by a heavy object falling on the hand or the hand being trapped in a door.
Above: Soft tissue massage and mobilisation of the carpal bones and the surrounding connective tissues
What are the symptoms of crush injury of the hand?
- reduced range of movement
- weakness
- stiffness
- cramps
What should I do if I have a crush injury of my hand?
You must go to your nearest accident and emergency department as soon as possible to get your injury treated. You should apply ice to the area either with an ice pack or frozen peas wrapped in a wet towel for up to 20 minutes at a time. This will help to reduce the swelling. You can also add compression with a bandage to minimise the swelling further. You may need a hand X-ray to check if any bones are broken. An MRI scan will be advised if there is extensive soft tissue damage and they will determine any injury to tendons, muscles or ligaments. From here, you will be given an accurate diagnosis and treatment plan which may involves surgery if the crush injury is very severe.
What shouldn’t I do if I have a crush injury of my hand?
You should not try and manage your symptoms on your own if you have experienced a crush injury to the hand. The sooner you get medical help, the greater chance that you will regain full function in your hand. It is also important that you prevent an increase in blood flow to the area. You should therefore avoid hot showers, heat packs and massage. Alcohol can also have this effect and so this should also be avoided.
Physiotherapy for a crush injury of the hand?
You may initially have to wear a cast or splint to rest your hand to allow it a chance to heal properly. However, you can still begin your physiotherapy programme which will focus on keeping other joints strong and mobile. Your treatment will include range of stretching and strengthening exercises for the hand to try and regain its normal function. This will reduce any stiffness and will allow you to return to your normal activities of daily living. Electrotherapy techniques such as ultrasound and laser therapy can also be used to accelerate tissue healing. Mobilisations may be carried out on certain joints in the hands to increase the movement in this area.
- Massage
- Acupuncture
- Wax therapy
- Taping
Can a crush injury of the hand have any long-term effects?
If several different structures are damaged, recovery will be a lot longer. You may also need surgery to repair broken bones or damaged tendons. If some of the nerves in the hand are damaged, you may experience pins and needles for several months until they regenerate. Whatever the extent of the crush injury, it is essential that you begin a physiotherapy programme as soon as the problem has been diagnose to reduce the risk of long-term complications.
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