An Update on the Management of Severe Crush Injury to the Forearm and Hand

Abstract

The main goals of treating severe crush injuries are debriding away devitalized tissue and filling any resultant dead space with vascularized tissue. In the authors' experience, the most ideal methods for soft tissue coverage in treating crush injuries are the iliac flap, the adipofascial lateral arm flap, and the gracilis flap. Accompanying bone defects respond very well to free corticoperiosteal flaps. Digital defects often require the use of complete or subtotal toe transfer to avoid amputation and restore function to the hand.

Keywords: Compartimental syndrome; Crush syndrome; Forzen hand; Free flap; Hand; Hand revascularization; Microsurgery.