Harvey S. Allen

Management of acute crushing injuries of the hand and forearm over a five-year period (1948–1952)

Abstract A review of 112 patients with acute crushing injuries of the hand and forearm is reported from the period of 1948 through 1952. The causes and types of injuries are cross indexed, and the local and remote complications are presented. The surgical principles of the management of acute crushing wounds are: protection of the wound from further contamination and trauma; mechanical cleansing of the wounds; thorough removal of devitalized tissues; repair of injured deep structures, if circumstances permit; reduction of fractures and closure of the wounds. We have emphasized the importance of maintaining the injured extremity in the position of function. In 108 patients, initial coverage of the wounds was accomplished by one or a combination of methods. The keystones to primary wound healing are removal of devitalized tissues and immediate closure of the wounds.