In a crush injury, the force of external force causes the skin, muscles and surrounding tissues to be crushed and the blood vessels to rupture. The destroyed blood vessels cause heavy bleeding, which can lead to bruising and severe swelling within the wound. It is usually the result of blunt force, for example in road traffic accidents or when trapped in the household or during sports. In comparison to a cut, there are no sharp wound edges and there are more abrasions. In addition, the risk of infection is very high in crush injuries.
Causes
Crush injuries occur most frequently in accidents involving high speeds or a lot of force, such as in road traffic, at home or during sports. In a car accident, for example, the impact causes a high external force to be exerted and this leads to massive entrapment in the tissue. Pinching when closing doors or windows can also lead to crush injuries to fingers or hands. During sports, dropping sports equipment on the foot or hitting the body with a racket can lead to crush injuries. Crush injuries in traffic accidents or serious falls are often accompanied by other injuries such as cuts and broken bones.
How is a crush wound different from a laceration?
Similar to the crush wound, the laceration is caused by a blunt force trauma. However, the laceration is the result of an indirect pulling action, which tears open the tissue and vessels. The tearing causes heavy bleeding.
In contrast to the crush wound, there are no abrasions at the wound edges, but they are also irregular and both tissue bridges are found. Crush and tear wounds often occur simultaneously (crush tear wound). The rule of thumb is that over time, a crush wound always occurs first and a laceration occurs when further force is applied.
Diagnosis
The diagnosis can usually be made directly by the treating physician on the basis of a detailed anamnesis of the patient about the course of the accident and the appearance of the wound. The typical picture of a crush wound with formation of a large, blue bruise, abrasions and swelling can quickly confirm the diagnosis of a crush wound. In order to exclude possible complications or further injuries, such as fractures or organ damage, further examinations should be carried out, such as X-rays, ultrasound or a computer tomography (CT).
