Crush Injury

[jennifer]

Hi all,

Patient after a terrible crush injury in a workplace..however, 3 times X-ray shows no sign of #. Coming to physio after 1 month post injury. Presenting to me with severe sharp excruciating pain especially on the dorsal aspect of wrist the MCP area of the 2,3,4 MCP. Pain is 5/10 but increase to 8/10 when extending all fingers. Unable to keep finger extended for more than 5 minutes(flexed fingers).increase sweating on the palm. when the wrist is left hang...the wrist and hand region will turn bluish.

On superficial palpation..patient c/o pain. I am thinking this must be a nerve injury..perhaps RSD (reflex sympathetic dystrophy/ CRPS)? so, I'm asking for anyone opinion on what are the appropriate treatment for him? He is not able to left the arm hanging..extremely pain.plus..the deltoid region and wrist flexors and extensors muscle wasted.

Current treatment for him:

- gentle massage to remove some of the swelling at the MCP joint
- active ex's for the fingers.
- wax therapy.

Do help me please, thanks.

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