Crush Injuries

A crush injury is a devastating event  since all anatomic structures in the crushed area are affected. Scar tissue forms more excessively than with other injuries and recovery can be very slow. We specialize in the complex, multi-faceted reconstruction needed to restore maximum possible function to your hand and wrist, offering hope in the face of severe trauma.

Crush Injuries help with Dr. Rod French

Rebuilding and Restoring Function After a Severe Crush Injury.

Hand crush injuries are devastating events since all anatomic structures in the crushed area are affected. Scar tissue forms more excessively than with other injuries and recovery can be very slow. We specialize in the complex, multi-faceted reconstruction needed to restore maximum possible function to your hand and wrist, offering hope in the face of severe trauma. 

Expertise for the Most Complex Hand Trauma. 

A severe crush injury is one of the most challenging traumatic events a person can face, creating immediate pain that can become chronic and a profound fear of permanent disability and the loss of your livelihood. We understand the gravity of your situation. Our practice is dedicated to providing the highest level of surgical expertise to manage these complex injuries and guide you on the long path to recovery. 

Treatment of the acute crush injury needs to be managed in a hospital setting where emergency departments can stabilize your condition and dedicated trauma operating rooms can provide initial surgical management.  Once that acute treatment is completed and you are discharged from hospital however, subsequent revisions or reconstructions are deemed “elective surgery”. This leaves patients often waiting months or longer for the secondary reconstructions needed to fix fractures that healed in the wrong position or not at all, tendons that have become stuck in scar tissue impeding joint motion, or unsightly scars that need revision. Accessing care for these later reconstructive efforts doesn’t have to wait for months or years. 

More Than Just a Broken Bone. 

A crush injury is a massive trauma that damages all of the intricate structures of the hand simultaneously. Unlike a simple fracture, the immense force of a crush injury can have devastating effects on every component required for function: 

  • Bone: Is often shattered into multiple pieces (comminuted fractures). 
  • Nerves: Delicate nerves responsible for feeling and muscle control can be stretched, torn, crushed, or severed. 
  • Blood Vessels: The arteries and veins that provide blood flow can be destroyed, jeopardizing the survival of the hand itself. 
  • Soft Tissues: Tendons that control movement and the overlying skin are severely damaged and get stuck to underlying fractures causing severe stiffness. 

A Multi-Faceted Approach to Reconstruction. 

Repairing Crushed Bone

  • The first step in this major surgery is to create a stable foundation. This involves meticulously cleaning the wound and piecing the crushed bone fragments back together. Dr. French uses plates, screws, and wires to rigidly fix the fractures. In cases of significant bone loss, bone grafting may be required to bridge the gaps and provide a scaffold for new bone to grow. 

Nerve Repair & Microsurgery 

  • Restoring sensation and muscle function is critical. Using a high-powered microscope, Dr. French performs microsurgery to painstakingly perform nerve and blood vessel repairs, suturing the delicate nerve endings back together. This highly specialized technique is essential for giving you the best possible chance of regaining feeling and movement. 

Restoring Blood Flow

  • The survival of the hand depends on blood flow. Microsurgery is also used to repair damaged arteries and veins, re-establishing circulation to the injured tissues. This is a critical and complex step in saving a severely crushed hand. 

Soft Tissue Reconstruction

  • Once the underlying structures are stable, the final step involves repairing tendons to restore movement and providing skin coverage over the wound, sometimes requiring skin grafts or more complex tissue transfers (flaps). 

The Critical Role of a Reconstructive Microsurgeon. 

The outcome of a crush injury repair hinges on the surgeon’s ability to operate on structures that are often less than a millimeter in diameter. This  often requires specialized training. Dr. French’s Harvard fellowship in Hand and Microsurgery provides the expertise required for these demanding procedures. His background as a plastic surgeon ensures a comprehensive approach, addressing bone, nerves, vessels, and skin to reconstruct the hand as a whole functional unit. 

Important Notice for Acute Injuries 

If you have sustained a severe, traumatic injury, please go to the nearest emergency room or call 911 immediately. Our practice provides specialized consultation and surgical reconstruction for patients once their condition is stable. 

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