Crush injuries

A crush injury occurs when excessive force or pressure is applied to a body part, leading to severe trauma. In the case of the feet, this type of injury results in the foot being compressed between two hard surfaces, potentially damaging bones, soft tissues, and nerves. It’s considered a serious form of foot fracture, as the intense pressure can cause significant harm to the structures within the foot.

Foot crush injury symptoms

There are a variety of symptoms you may experience depending on the nature of the accident and cause. Before making a definitive diagnosis, our podiatrists work to identify several symptoms, which may include:

  • Fractures or breaks
  • Lacerations
  • Level of pain
  • Bruising or swelling
  • Numbness

Untreated crush injuries can lead to more severe conditions and symptoms, including:

  • Compartment syndrome: A condition that involves dangerously high levels of pressure inside the body compartment, often when muscles are deprived of blood for too long
  • Necrosis: The death of tissue as a result of blood deprivation
  • Rhabdomyolysis: A rare condition that happens when dead muscle content are released into your bloodstream, which can cause kidney failure
  • Infection: Crush injuries are often widespread and not clean, making infection a common occurrence in untreated cases

Types of foot crush injuries

Foot crush injury types vary in severity. A podiatrist will perform a thorough physical exam and history review, as well as information on the type of force applied to the foot, to determine the type of crush injury you may have suffered. Types of foot crush injuries include:

  • Type I: Occurs when the crushing object is heavy, large, and has contact with the foot for a long period of time, causing a bone or soft tissues to experience a gradual crush
  • Type II: Involving the same experience as Type I injuries, this type includes the presence of lacerations that cause a mangling of tissues and is often associated with open or compound fractures
  • Type III: This type is the most severe, typically involving degloving from a tangential type force and often life-threatening

What is crush injury compartment syndrome?

Crush injury compartment syndrome is a condition that results from bleeding or swelling after an injury. Crush injury compartment syndrome is a medical emergency that often requires immediate surgery to prevent permanent injuries like severe tissue damage, loss of body function, or death.

Types of compartment syndrome

Acute compartment syndrome occurs most often during bone breaks and foot crush injuries. It involves a build-up of high pressure inside the muscle compartments of the foot, impeding blood flow to and from impacted tissues. Other types of compartment syndrome include:

  • Chronic exertional compartment syndrome: Developing over days or weeks, this form typically affects the lower legs, thighs, or buttock, and can be caused by excessive physical activity or rigorous, regular exercise
  • Abdominal compartment syndrome: Occurring after a major injury, surgery, or while critically ill, this form can affect the liver, bowls, kidneys, and other important organs

Signs of compartment syndrome

Crush injury compartment syndrome can develop within hours or over the course of days with symptoms often not presenting until later on. Common symptoms include:

  • Bruising, swelling, or tightness
  • Intense pain that doesn’t make sense for the injury you’ve suffered
  • Tingling, pins-and-needles, or numbness
  • A new, persistent ache in the affected area

Diagnosing crush injury compartment syndrome requires a physical exam and pressure check. Your provider may insert a needle into the affected body part and use a pressure monitor to measure the pressure inside the area.

Treating crush injury compartment syndrome

If diagnosed with crush injury compartment syndrome, you may need to undergo surgical decompression. Other treatments can include providing oxygen, pain medications, elevating the body part, or providing fluids intravenously.

Foot crush injury treatments

Treatment for foot crush injuries depend on type, severity, cause, and location of the trauma. No matter these factors, you should always see a podiatrist or other physician if you’ve suffered a crush injury of the foot. Our podiatrists will help you understand the extent of the injury, ensuring it’s properly diagnosed and treated.

Minor crush injuries

Minor crush injuries like those caused by dropping moderately heavy items, like a book, on your foot tend to heal on their own. This is because the damage in these cases often only impacts the superficial soft tissue in your foot, which is usually minor and marked with a bruise. Ice and compression can help to reduce pain and swelling.

Least severe cases

The least severe crush injuries, such as Type I or lesser cases, can involve broken bones. Your podiatrist or physician may recommend flat-bottom footwear and using crutches. When combined with close monitoring, your injury may heal on its own from there. However, if the broken bones aren’t aligned, you may need to take extra steps with your podiatrist to realign them, which may result in needing to wear a cast after the fact.

Severe cases

The most severe crush injuries can require foot reconstruction surgery, especially if there are multiple bone fractures and extensive soft tissue damage. The most extreme cases can require amputation, but only if the foot is beyond repair.