Crush injuries of the hand

A retrospective review of 58 patients presenting with crush injuries of the hand within the 6 year period April 1984 to March 1990 was undertaken. The male-female ratio was 3:1, with a mean age of 25.13 +/- 15.1 years. The peak incidence was in the 3rd decade of life. Machines (55.17%) were the commonest cause with the pepper grinder featuring most prominently. The dorsum (60.3%), little (55.1%) and ring (53.5%) fingers of the right hand were the most commonly involved. Most of the injuries were multiple. Management was mainly conservative and entailed initial limited debridement, thorough washing with soap and water under adequate anaesthesia, bulky boxing glove dressing, elevation, antibiotics and early hand physiotherapy with late reconstruction. Results were excellent in 13 (22.41%), good in 19 (32.76%) poor in 23 (39.66%) and unknown in 3 (5.17%) who were lost to follow-up. Our poor result is perhaps the warning signal that we should abandon our extreme conservative stance and be more aggressive in our attitude to these injuries.