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A crush injury occurs when a body part is compressed, causing damage to muscles, nerves, blood vessels, bones, and other tissues. Severe crush injuries require immediate medical attention to prevent complications, such as rhabdomyolysis, which can lead to kidney failure, shock, and death. Prevention of crush syndrome is a primary goal of treatment, which may include surgery, intravenous fluids, antibiotics, and a tetanus shot. Nearly three-quarters of crush injuries affect the legs.
A crush injury is caused by sustained or forceful compression of a body part, such as an arm or leg, which causes damage to muscles, nerves, blood vessels, bones, and other tissues. While a minor crush injury, such as a finger slamming a door shut, can sometimes be treated at home, serious crush injuries are medical emergencies that require immediate attention to prevent complications and preserve function in the affected body part. The most common scenarios for severe crush injuries are accidents, such as motor vehicle collisions, and natural disasters, such as earthquakes.
In a crush injury, the normal chemical balance of muscle cells is disrupted due to abnormal compressive forces. Direct injury to the muscle damages structures in cell membranes that pump calcium and potassium into cells and sodium out of cells. Increased calcium levels within muscle cells cause the enzymes normally found there to become destructive to muscle tissue. This destruction can lead to the rupture, or rupture, of the muscle cell membrane and result in cell death.
The rupture of the muscle cell membrane causes substances to leak out of the cell. These substances, which include potassium, calcium, creatinine and myoglobin, a protein that normally supplies muscle cells with oxygen, can then enter the bloodstream. The release of these chemicals into the body’s circulatory system is known as rhabdomyolysis. Left untreated, rhabdomyolysis can lead to kidney failure, shock, and ultimately death. A person with a crush injury who shows signs of damage to other body systems is said to have crush syndrome.
Prevention of crush syndrome is a primary goal of crush injury treatment. Patients are given intravenous fluid containing both sodium bicarbonate and mannitol to prevent kidney damage and stabilize blood pressure. You may need surgery to repair nerve and bone damage. To prevent infection, patients may receive antibiotics and a tetanus shot.
Statistics on the incidence of crush injuries come primarily from reports from health care workers who have treated people injured in natural disasters, such as earthquakes. Nearly three-quarters of crush injuries affect the legs, with about 10% of injuries affecting the arms and just under 10% affecting the trunk. In the United States, information about crush injury and crush syndrome treatment is part of the federal emergency preparedness and response system.
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