Dr. Muh.

Sakti SpOT

Crush Injury Dened

Injuries in which damaging forces are passed
from the exterior of the body to internal
structures because the body or some part of it
has been compressed between to or more
surfaces.
May result in open or closed wounds

Anatomy of the foot

Hind foot is formed by
talus and calcaneus.
Midpart: calcaneus
a r ? c u l a ? n g w i t h
cuboid and talus with
navicular bone, both
a r ? c u l a t e s w i t h
cuneiforms
Forefoot: metatarsal
and phalanges

Anatomy of the Foot

Ar#cula#ons:
1.
2.
3.
4.
5.
6.

Subtalar (talocalcaneal)
Tarsometatarsal Joint
Mid-tarsal Joint
Intermetatarsal Joint
Metatarsophalangeal Joint
Interphalangeal Joint

Ligament:

Plantar calcaneonavicular ligament (spring ligament)

Anatomy of the Foot

Arches:

The bones of the foot are arranged in arches to absorb the changing forces and
terrains. The shape of the bones and their rela?on to each other maintains
arches.
1. Medial longitudinal arch
2. Lateral longitudinal arch
3. Transverse arch

Func?on of arches
Stability
Distribu?on of weight

Mobility
Dampens shock of weight bearing
Adapta?on to changes in support surfaces
Dampening of superimposed rota?ons

Foot func?on
1. Accept ver?cal forces during heel strike
2. Absorb and dissipate these forces across a
exible mid- and forefoot during prona?on
3. Provide propulsion as the foot becomes a
rigid lever with resupina?on and toe-o

Anamnesis
High-energy injury
A crush injury in the heel, such as an industrial injury
from:
a forkliW,
power machine,
severe injury that is unfortunately fairly common and
mostly due to gravity.

Clinical Examamina?on
Have a great bone and soW ?ssue damage
(fracture & disloca?on of the calcaneal or
subtalar joint)
a closed degloving.
Compartment syndrome should be carefully
monitored in such pa?ents, and it is wise to
admit these individuals and elevate and splint the
foot with daily neurovascular examina?on, as
well as evalua?on of pain control.
Heel pad avulsion

Examina?on
Look
Swelling
Bruising
Lacera?on
Deformity esp
Dislocated ankle

Feel
Where tender
Palpable deformity
Pulses

Feel

Base of 5th
Metatarsal

Neurovascular
Check pulses
Capillary rell
Colour and
temperature
Check sensa?on

Examina?on
Move
Range of movement
Any pain on movement

Radiographs
A-P, lateral, mor?se
views WEIGHT
BEARING
Looking for fracture,
disloca?on, abnormal
widening of clear
space
Dont forget to image
the foot if clinically
indicated
A-P View of Ankle

Radiographs

Lateral View of Ankle

Mortise View of Ankle

SOLE
Lacera?ons
Puncture Wounds
Treatment = Tetanus,
An?bio?cs,
Debridement,

treatment
Fractures

nondisplaced = cast
displaced = ORIF

TREATMENT
pa?ent with Compartement
syndrome
Treatment = Fasciotomy