Abstract
Introduction Crush injuries result from physical compression of muscles and may lead to crush syndrome, which describes the systemic manifestations of traumatic rhabdomyolysis such as acute kidney injury. Early fluid resuscitation and surgical intervention is key. This retrospective study aims to characterise such cases.
Methods Patient with lower limb crush injuries were identified from an internal database. Non-crush injuries and patients under the age of 18 were excluded. Types of injuries, management, and complications were extracted.
Results 27 patients were included. Patients were categorised into two groups according to site of injury above the talus (A) or isolated injury to the foot (B). The right leg (37%) was the most frequently injured site. Mechanisms included being run over by vehicles (37%) and being crushed by, between, or inside vehicles (29.6%). Fractures were the most common acute injuries (59.2%). Group A experienced a greater injury burden including fractures, rhabdomyolysis, and compartment syndrome. Fluid resuscitation was required in 63% of patients, 70.4% received intravenous antibiotics, and surgical management consisted of 58 operations. Systemic complications such as sepsis and acute kidney injury were seen in group A but not group B.
Conclusion Crush injuries in the non-disaster setting show distinct mechanisms and injury patterns. Those with crush injuries to the leg more closely resemble a patient cohort seen in the disaster setting.