Crush injury (CI) is defined as a direct and local injury to the limbs that is caused by continuous prolonged pressure, basically causing damage to the muscle cells. Crush syndrome (CS), or reperfusion syndrome, is the systemic manifestation of CI (systemic pathopysiological and biochemical clinical picture, e.g. renal failure). As the definition indicates, a victim must be either buried or pinned down for a substantial period of time for CI to develop. The minimal time for this process, as delineated by Bywaters, is 2 hours.1,2 While one report mentions less than 1 hour,3 the usual time is much longer. This limits the cases of developing CI to patients whose extrication is delayed, and the obvious scenarios are mine accidents, tunnel accidents, earthquakes, and bombed buildings.3–6 It is also highly relevant to terrorist attacks. In each of these scenarios, extrication may take a long time because of technical problems.
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References
Bywaters EG. Ischemic muscle necrosis. JAMA. 1944;124:1103–1109
Bywaters EG, Beall D. Crush injuries with impairment of renal function. 1941. J Am Soc Nephrol. 1998;9:322–332
Ron D, Taitelman U, Michaelson MM, Bar-Joseph G, Bursztein S, Better OS. Prevention of acute renal failure in traumatic rhabdomyolysis. Arch Intern Med. 1984;144:277–280
Santangelo ML, Usberti M, Di Salvo E, et al. A study of the pathology of crush syndrome. Surg Gynecol Obstet. 1982;154:372–374
Brown AA, Nicholls RJ. Crush syndrome: a report of 2 cases and a review of the literature. Br J Surg. 1977;64:397–402
Jones RN. Crush syndrome in a Cornish tin miner. Injury. 1984;15:282–283
Bentley G, Jeffreys TE. The crush syndrome in coal miners. J Bone Joint Surg Br. 1968;50:588–594
Michaelson M, Taitelman U, Bshouty Z, Bar-Joseph G, Bursztein S. Crush syndrome: experience from the Lebanon War, 1982. Isr J Med Sci. 1984;20:305–307
Michaelson M, Taitelman U, Bursztein S. Management of crush syndrome. Resuscitation. 1984;12:141–146
Reis ND, Michaelson M. Crush injury to the lower limbs. Treatment of the local injury. J Bone Joint Surg Am. 1986;68:414–418
Better OS, Michaelson M, Taitelman U, Zinman C, Reis DN. Rescue and salvage operations for casualties with the crush syndrome. Postgrad Gen Surg. 1990;2:189–196
Shimazu T, Yoshioka T, Nakata Y, et al. Fluid resuscitation and systemic complications in crush syndrome: 14 Hanshin-Awaji earthquake patients. J Trauma. 1997;42:641–646
Zui-Yong Z. Medical support in the Tangshan earthquake: a review of the management of mass casualties and certain major injuries. J Trauma. 1987;27:1130–1137
Matsuoka T, Yoshioka T, Tanaka H, et al. Long-term physical outcome of patients who suffered crush syndrome after the 1995 Hanshin-Awaji earthquake: prognostic indicators in retrospect. J Trauma. 2002;52:33–39
Shimazu T, Yoshioka T, Nakata Y, et al. Fluid resuscitation and systemic complications in crush syndrome: 14 Hanshin-Awaji earthquake patients. J Trauma. 1997;42:641–646
Sever MS, Erek E, Vanholder R, et al. Renal replacement therapies in the aftermath of the catastrophic Marmara earthquake. Kidney Int. 2002;62:2264–2271
Sever MS, Erek E, Vanholder R, et al. Lessons learned from the Marmara disaster: time period under the rubble. Crit Care Med. 2002;30:2443–2449
Sever MS, Erek E, Vanholder R, et al. Treatment modalities and outcome of the renal victims of the Marmara earthquake. Nephron. 2002;92:64–71
Sarisozen B, Durak K. Extremity injuries in children resulting from the 1999 Marmara earthquake: an epidemiologic study. J Pediatr Orthop B. 2003;12:288–291
Kikta MJ, Meyer JP, Bishara RA, et al. Crush syndrome due to limb compression. Arch Surg. 1987;122:1078–1081
Michaelson M, Reis ND. Crush injury — crush syndrome. Unfallchirurg. 1988;91:330–332
Reis ND, Better OS. Mechanical muscle-crush injury and acute muscle-crush compartment syndrome. J Bone Joint Surg. 2005;87-B:450–453
Better OS. Traumatic rhabdomyolysis (“crush syndrome”) — updated 1989. Isr J Med Sci. 1989;25:69–72
Better OS, Stein JH. Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis. N Engl J Med. 1990;322:825–829
Gabow PA, Kaehny WD, Kelleher SP. The spectrum of rhabdomyolysis. Medicine (Baltimore). 1982;61:141–152
Michaelson M. Crush injury and crush syndrome. World J Surg. 1992;16:899–903
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Michaelson, M. (2009). Crush Injury, Crush Syndrome. In: Shapira, S.C., Hammond, J.S., Cole, L.A. (eds) Essentials of Terror Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09412-0_20
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