Crush injuries

Crush injuries of the forefoot are classified 89C fractures.

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.

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.

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

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