Crush Injury and Extremity Compartment Syndromes

Lee, Nathaniel; Peysha, Jill; Ferrada, Paula

doi:10.1007/s40719-018-0141-3

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…Renal failure is multifactorial and results in combinations of multiple causes, including hypovolemia and the release of large quantities of nephrotoxic substances from injured muscle cells. Electrolyte abnormalities such as hyperkalemia can cause negative inotropy and potentially fatal arrhythmias [5]. Early uid resuscitation, within the rst six hours, is essential [6].…”

Section: Introductionmentioning

confidence: 99%

6 February 2023, Orthopedic experience in Kahramanmaras Earthquake and surgical decision in patients with crush syndrome

KUNDAKÇI

Mirioğlu

Tekin

et al. 2023

Preprint

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Background: The decision of fasciotomy or amputation in crush syndrome is controversial and challenging for surgeons. We aimed to share our experiences after the Kahramanmaraş Earthquake, to predict the severity of crush syndrome and mortality, and to guide the surgical decision. Methods: The clinical data of patients during their first week of hospitalization were analyzed retrospectively. Totally 233 crush syndrome patients were included. Demographic data, physical and laboratory findings, surgical treatments, and outcomes were recorded. Results: The mean time under the rubble was 41.89±29.75 hours. Fasciotomy and amputation were performed in 41 (17.6 %) and 72 (30.9%) patients. One hundred and two patients (56.7%) underwent hemodialysis. Fifteen patients (6.4%) died. Lower extremity injury, abdominal trauma, and thoracic trauma were associated with mortality. Mortality was significantly increased in patients with thigh injuries (p=0.028). The mean peak CK concentration was 69.817,69 ± 134.812,04 U/L. Peak CK concentration increased substantially with amputation (p=0,002), lower limb injury (p<0.001), abdominal trauma (p=0.011), and thoracic trauma (p=0.048). Conclusions: Thigh injury is associated with the severity of crush syndrome and mortality. Late fasciotomy should not be preferred in crush syndrome. Amputation is life-saving, especially in desperate lower extremity injuries.

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Section: Introductionmentioning

confidence: 99%

6 February 2023, Orthopedic experience in Kahramanmaras Earthquake and surgical decision in patients with crush syndrome

KUNDAKÇI

Mirioğlu

Tekin

et al. 2023

Preprint

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“…Crush injury is defined as compression of the extremities or other parts of the body that cause muscle swelling and or neurological disorders in the affected areas of the body. 1 In addition, crush injuries will have decreased blood flow related to the damage of tissues and edema. 2 Hyperbaric oxygen therapy acts through the ideal gas laws and is effective as an adjunctive therapy in the treatment of crush injuries.…”

Section: Introductionmentioning

confidence: 99%

Management of Crush Injury’s Complications Using Hyperbaric Oxygen Therapy: Case Series

Arikalang,

Hatibie,

Oley

et al. 2023

eCl

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Crush injury occurs due to an external trauma mechanism that directly affects the skin, muscle, and bone tissue. Crush injuries can involve several parts of the body at the same time. When accompanied by handling, wound healing in crush injury can be long-term, so that it can affect the function of the patient. Various complications that can occur ranging from secondary infection, necrosis, recurrent bleeding, to compartment syndrome. We reported serial cases of crush injury with various clinical presentations and complications, varying in the age range of 16-65 years. All four patients were given multiple managements, such as open reduction external fixation and extensive debridement. There were complications such as secondary infection and delay in the wound healing process in patients who did not on time for follow-up. The four patients received additional treatment in the form of wound dressings hyperbaric oxygen therapy (HBOT) with 5-10 90-minute sessions under 2.4 ATA pressure for 10 consecutive days. Follow-up was carried out again within a period of one month to compare the wound condition before and after HBOT. The clinical condition was getting better, marked by the formation of granulation tissue. The state of hyperoxia in HBOT accelerated the inflammatory process and angiogenesis during the wound healing process characterized by the eradication of bacteria in the wound tissue and accelerated neovascularization formation. In conclusion, adequate therapy, wound dressing, and patient compliance affect patient outcome. Moreover, the addition of hyperbaric oxygen therapy has shown to accelerate the wound healing process and restore the patient's limb function. Keywords: crush injury; hyperbaric oxygen therapy; oxygen; wound healing

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6 February 2023, orthopedic experience in Kahramanmaraş earthquake and surgical decision in patients with crush syndrome

et al. 2023

View full text Add to dashboard Cite

Background The decision of fasciotomy or amputation in crush syndrome is controversial and challenging for surgeons. We aimed to share our experiences after the Kahramanmaraş earthquake, to predict the severity of crush syndrome and mortality, and to guide the surgical decision. Methods The clinical data of patients during their first week of hospitalization were analyzed retrospectively. Totally, 233 crush syndrome patients were included. Demographic data, physical and laboratory findings, surgical treatments, and outcomes were recorded. Results The mean time under the rubble was 41.89 ± 29.75 h. Fasciotomy and amputation were performed in 41 (17.6%) and 72 (30.9%) patients. One hundred and two patients (56.7%) underwent hemodialysis. Fifteen patients (6.4%) died. Lower extremity injury, abdominal trauma, and thoracic trauma were associated with mortality. Mortality was significantly increased in patients with thigh injuries (p = 0.028). The mean peak CK concentration was 69.817.69 ± 134.812.04 U/L. Peak CK concentration increased substantially with amputation (p = 0.002), lower limb injury (p < 0.001), abdominal trauma (p = 0.011), and thoracic trauma (p = 0.048). Conclusions Thigh injury is associated with the severity of crush syndrome and mortality. Late fasciotomy should not be preferred in crush syndrome. Amputation is life-saving, especially in desperate lower extremity injuries.

show abstract

Crush Injury and Extremity Compartment Syndromes

Cited by 4 publications

References 29 publications

6 February 2023, Orthopedic experience in Kahramanmaras Earthquake and surgical decision in patients with crush syndrome

6 February 2023, Orthopedic experience in Kahramanmaras Earthquake and surgical decision in patients with crush syndrome

Management of Crush Injury’s Complications Using Hyperbaric Oxygen Therapy: Case Series

6 February 2023, orthopedic experience in Kahramanmaraş earthquake and surgical decision in patients with crush syndrome

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