A Washington woman is currently being treated for severe crush injuries following a climbing accident in which she was struck by a 3,000 pound boulder.
21-year-old Andrea Haisch was with her family, watching her brother climb an established climbing wall when a large rock detached from the wall and pinned her to the ground.
Andrea broke her pelvis, forearm, and sustained leg injuries that may result the loss of her left foot and ankle. Her brother also broke his tailbone and two of his vertebrae.
Dr. Silverman Comments
Crush injuries are incredibly challenging to treat. A heavy weight dropped from any height causes damage that is hard to accurately interpret on the date of the injury. Unlike Wiley Coyote, when a part of the body is crushed it doesn’t just magically re-inflate.
The crushed limb often looks a lot better than it actually is. There may be only bruising and swelling with an otherwise normal shape. The bones are rarely crushed, but in this circumstance, the skin and the x-ray appearance is very misleading. Beneath the skin, massive damage has occurred. While nearly all the underlying soft tissue has been torn off the bone from the inside out, the skin (being the most elastic), appears intact.
The amount of tissue death depends on the energy of the crushing force. In some circumstances, fracture blisters develop on the skin within a few days. Compartment syndrome can accompany this type of injury, requiring emergency surgery to save the limb. In other injuries, a black scab forms on the skin. This black scab = dead tissue. Preventing infection with surgical debridement and careful and aggressive wound care is essential.
Early involvement of experienced trauma trained orthopaedic surgeons, plastic surgeons, and verteran nurses can make all the difference in limb survival and the function of the surviving limb.
The full extent of this woman’s injury will not be known for many days. Patience and preparation for the worst is the most prudent choice. These doctors are wise to warn about the risks of limb loss.
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