Crush Syndrome due to Limb Compression

Kikta, Michael J.; Meyer, Joseph P.; Bishara, Rashad A.; Goodson, Spencer F.; Schuler, James J.; Flanigan, D. Preston

doi:10.1001/archsurg.1987.01400210116019

Cited by 44 publications

(25 citation statements)

References 26 publications

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“…A crushing injury to a large mass of skeletal muscle or myonecrosis secondary to muscular ischemia results in extensive cell death and rhabdomyolysis. The release of intracellular constituents leads to systemic and metabolic consequences including myoglobinemia, myoglobinuria, hyperkalemia, metabolic acidosis, coagulation defects, and, ultimately, shock [6][7][8][9][10][11][12]. Compartment syndrome, which can develop together with these clinical situations, is defined as swelling and increased pressure within closed tissue spaces at the injury site with compromise of blood flow leading to sensory and motor disturbances and pain [12].…”

Section: Discussionmentioning

confidence: 99%

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Crush Injury in Two Earthquake Disasters within a 3-Month Period

Kurt¹,

Küçük²,

Demirhan³

et al. 2003

European Journal of Trauma

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Background: This study describes our one-center experience in crush injury and compartment syndrome sustained in the Marmara and Düzce earthquakes that hit the region within a 3-month period. Patients and Methods: We reviewed medical records of patients with crush injuries from the two earthquakes and analyzed treatment, morbidity and mortality rates. Results: A total number of 75 patients with crush injury was seen. Mean entrapment time was 14 (±10) and 6 (±4) h in the Marmara and Düzce earthquakes, respectively (p < 0.01). Fasciotomy was performed in 43 patients who developed compartment syndrome. 38.6% of the patients (n = 29) had sustained associated injuries, and 25.3% of the patients (n = 19) showed more than one organ system injury. Hemodialysis was performed in 35 patients. Ten patients required amputation. The total infection rate was 37.3%. Total mortality rate amounted to 14.6%. Increased entrapment times led to a higher mortality rate, although the association was not statistically significant. Conclusion: Crush injury and compartment syndrome are frequently seen after earthquakes and associated with a high mortality. These patients should receive multidisciplinary treatment.

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Section: Discussionmentioning

confidence: 99%

“…As a result, systemic inflammatory response and tissue damage ensue [7,20,26]. Reperfusion-mediated cellular injury can lead to further edema and intracompartmental hypertension.…”

Section: Discussionmentioning

confidence: 99%

Crush Injury in Two Earthquake Disasters within a 3-Month Period

Kurt¹,

Küçük²,

Demirhan³

et al. 2003

European Journal of Trauma

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“…The various causes can be divided into problems that decrease the size of the compartment or increase the content of the compartment [6][7][8][9][10][11][12][13][14][15]. Procedures or processes that alter the compartment contents or size are listed in Table 1.…”

Section: Epidemiology and Etiology Of The Compartment Syndromementioning

confidence: 99%

Epidemiology, Etiology, Pathophysiology and Diagnosis of the Acute Compartment Syndrome of the Extremity

Janzing

2007

Eur J Trauma Emerg Surg

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Due to an insult that causes a pressure elevation in the compartment, which is the limited space surrounded by the unyielding bone and fascia, the circulation is compromised resulting in muscular and neural ischemia and eventually tissue necrosis. The diagnosis of the compartment syndrome has always been based on the clinical symptoms, however, multiple studies suggested that clinical examination alone is insufficient and may result in delayed diagnosis, delayed treatment and serious sequelae. To avoid delayed diagnosis and treatment the use of compartment pressure monitoring has been advised. There is, however, no consensus about the indications for the compartment pressure monitoring, or about the threshold pressure that should be used for dermatofasciotomy. A diagnostic guideline is proposed.

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“…The muscle decay can also be the result of rhabdomyolysis due to internal causes, e.g., by the action of snake venom or drug side effects. [8][9][10][11][12][13][14][15][16] A rare complication in i.v. drug abusers is the occurrence of compartment syndrome, which can be triggered by a long-lasting compression of one or more parts of the extremities while the patient is in a druginduced coma.…”

Section: Introductionmentioning

confidence: 99%