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Upper Extremity Crush Injuries

What are Upper Extremity Crush Injuries?

A crush injury of the upper extremities refers to damage that occurs when external forces or pressure is exerted over the upper extremities. These injuries most often happen when any part of your upper extremities including your hand and fingers are squeezed between two heavy objects resulting in trauma to the soft tissues, muscles, nerves, and bone.

What are the Risk Factors for Upper Extremity Crush Injuries?

Crush injuries are a major concern to workers and organizations where high-risk activities are performed daily such as construction, drilling, and refining works. These activities are often done in extreme environments and hands may easily be exposed to hazards that cause crush and pinch injuries.

What are the Causes of Upper Extremity Crush Injuries?

Traumatic crush injuries of the upper extremities could be a result of the following:

  • Motor vehicle accidents
  • Falling from heights
  • l-Fingers getting trapped in closing doors
  • Hands being stuck under heavy objects

What are the Signs & Symptoms of Upper Extremity Crush Injuries?

Signs and symptoms related to upper extremity crush injuries include:

  • Severe bleeding
  • Highly intense pain
  • Bruising over the hand
  • Compartment syndrome (increased pressure in an limb that causes serious muscle, nerve, blood vessel, and tissue damage)
  • Bone fractures
  • Laceration (open wound)
  • Nerve injury
  • Ligament and tendon injuries
  • Numbness, stiffness in the hand
  • Loss of strength and range of motion in the hand

How are Upper Extremity Crush Injuries Diagnosed?

Depending on the severity of the damages incurred, traumatic crush injuries of the upper extremities may be diagnosed using the following methods:

  • Physical examination
  • Blood tests
  • X-rays
  • MRI scan
  • CT scan

How are Upper Extremity Crush Injuries Treated?

First Aid

In cases of open wounds, bleeding may be stopped by applying direct pressure over the wound. The injured area can be covered with a wet cloth or bandage. If possible, raise the hand above the level of the heart. If a head, neck, or spinal injury is suspected along with the upper extremity crush injury, then immobilize those areas and limit movement.


If you have had a moderate or mild crush injury, you will need to visit a doctor immediately for evaluation. Your doctor may clean the injured site and administer antibiotics, depending on the cause of the injury. Pain relievers will be given to reduce pain and steroids to decrease inflammation.


Serious crush injuries most often need to be treated surgically. A fasciotomy or a surgery to reduce pressure on the muscles and nerves may be needed. If medical attention is not provided promptly and the injury is left untreated for a long period of time, necrosis of tissue may occur and it might be necessary to amputate the part. In extreme cases, multiple surgeries may be needed, to repair the muscles, nerves, tendons, and bones completely.

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  • AO Trauma
  • American Association for Hand Surgery
  • American Society for Surgery of the Hand
  • American Academy of Orthopaedic Surgeons
  • American Foundation for Surgery of the Hand