Authors of section

Authors

Khairul Faizi Mohammad, Brad Yoo

Executive Editors

Markku T Nousiainen, Richard Buckley

Open all credits

Crush injuries

Definition

Crush injuries of the forefoot are classified 89C fractures.

87 D900 Definition

Clinical signs

The following clinical presentation is typical:

  • There is significant soft tissue damage and swelling.
  • Open fractures are common.
  • The patient describes an acute high energy trauma with immediate pain and cannot weight bear.
  • The mechanism involves high energy axial load or crush.
  • There is significant soft tissue damage and swelling.
  • The damaged area is very painful to palpation and weight bearing.
  • Significant deformity is common, and sensation can be disrupted, particularly plantarly.
  • There will be crepitation and instability with palpation of the affected area (this will be very painful for the patient).
  • Vascular compromise may be present and should be assessed.
Clinical picture

Imaging

Conventional radiographs of the foot. AP and lateral oblique views are sufficient for diagnosis and treatment.

CT scans are invaluable for clarification of the fracture pattern as well as assessment of additional fractures of the midfoot.

X-ray

Mechanism of injury

High impact injury with axial load or direct crush injury to the forefoot.

Associated injuries

Compartment syndrome, forefoot, midfoot or hindfoot fractures and instabilities.

Go to indication