Figure grisly

Figure Legend: Dramatic injuries should prompt heightened suspicion that other regional injuries exist.  This patient sustained bilateral proximal forearm burn and crush injuries when both arms were caught in an industrial roller press (1,2,3).  In addition to the obvious wounds at the elbow level, all distal structures were crushed (4) and had lengthy ischemic time, making salvage impossible, and resulting in bilateral elbow disarticulations.
 
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