Hand or Finger Crush Injury, No Fracture (Child)

Your child has a crush injury of the hand, finger(s), or both. A crush injury happens when a large amount of pressure is put on part of the body. This squeezes the area between 2 surfaces. Your child has no broken bones, but tissue has been damaged. This injury can cause pain, swelling, and bruising. If the skin is broken, there will be bleeding.

Your child may be given a splint to protect the injured hand or finger while it heals. If a fingernail has been injured, it may fall off. A new one will likely grow back within about a month.

Home care

Follow these guidelines when caring for your child at home:

  • Your child's healthcare provider may prescribe medicine for swelling and pain. Follow the provider's instructions for giving this medicine to your child. If pain medicine was not prescribed, ask the provider what medicine to give your child for pain or discomfort. Don’t give aspirin to your child unless the provider tells you to.

  • If the wound starts bleeding, put pressure directly on the spot that’s bleeding. Keep the pressure on for 10 minutes. Don’t stop or peek at it.

  • Keep the affected hand raised to ease pain and swelling. This is most important during the first 2 days (48 hours) after injury. Have your child sit or lie down as often as possible. Put pillows under your child's arm until the affected hand is raised above the level of the heart. Keep an eye on the pillows so they don't slip and move near your child's face. This is especially important for babies and young children. Never leave your child unsupervised.

  • Unless told otherwise, put a cold pack on the injury to help control swelling. You can make an ice pack by wrapping a plastic bag of ice cubes in a thin towel. As the ice melts, be careful that the splint doesn’t get wet. Most children don’t like the feel of the cold. Don’t force your child to use the cold pack. This could make both of you miserable. Sometimes it helps to make a game of it.

  • Unless told otherwise, use the cold pack for up to 20 minutes every 1 to 2 hours the first day. Continue this 3 to 4 times a day for the next 2 days, then as needed. The cold pack can be placed directly on the splint.

  • Care for the splint as you've been told. Don't put any powders or lotions inside the splint . Keep your child from sticking objects into the splint.

  • Keep the splint dry. When your child is bathing, protect the splint with a large plastic bag closed at the top with tape. Keep the splint out of the water when your child is bathing.

  • Care for any exposed cuts or scrapes as you have been told.

  • Watch for the signs of infection listed below.

Follow-up care

Follow up with your child's healthcare provider, or as advised. Call your child’s provider if your child doesn’t start to get better within the next 3 days.

Special note to parents

Healthcare providers are trained to recognize injuries like this one in young children as a sign of possible abuse. Several healthcare providers may ask questions about how your child was injured. Healthcare providers are required by law to ask you these questions. This is done to protect your child. Please be patient and do not take offense.

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below)

  • Signs of infection. These include redness, warmth, swelling, or drainage from a wound, or foul odor from the splint

  • Wet or soft splint or cast

  • Fingers on the injured hand are cold, blue, numb, burning, or tingly. If the splint is on, loosen it before seeking help.

  • Fussiness or crying in a baby that can’t be soothed

  • Swelling or pain gets worse. A baby who can’t yet talk may show pain with crying that can't be soothed.

  • Splint is too tight. If the splint is on, loosen it before seeking help.

  • Tingling in the hand or fingers that is new or getting worse

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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