Demographic and clinical features of extremity crush injuries resulting from entrapment under the rubble: An orthopedic perspective

Background: We aimed to contribute to the literature by reporting the demographic and clinical characteristics of patients who suffered extremity crush injuries as a result of being trapped under rubble following the earthquake that occurred in Turkey on February 6, 2023. Methods: In total, 65 patients, including 33 females and 32 males, were enrolled. The mean age of the patients was 32.2 ± 20.45 years. Patients were categorized into four treatment groups, including nonoperative (n = 13), fasciotomy/debridement (n = 20), fracture fixation (n = 5), and amputation (n = 27) groups. Demographic and clinical information were analyzed. Results: The lower extremities were the most frequently affected anatomical regions. Upon hospital admission, all patients exhibited significant elevations in serum potassium and creatinine kinase levels; however, these levels decreased significantly within 24 h of the initiation of operative or nonoperative treatment (p < 0.05). The rate of crush syndrome development was 54%, 60%, and 59% in the nonoperative, fasciotomy/debridement, and amputation groups, respectively. Similarly, the rate of hemodialysis was 15%, 35%, and 22% in the nonoperative, fasciotomy/debridement, and amputation groups, respectively. The reoperation rate was 75% and 30% in the fasciotomy/debridement and amputation groups, respectively. Furthermore, the incidence of infection was 40% in fracture fixation group, 40% in the fasciotomy/debridement group, and 33% in the amputation group. The mortality rate was 5% in the fasciotomy/debridement group and 7% in the amputation group. The mean duration of hospitalization for all treatment groups was 10.9 ± 10.41 days, with the fasciotomy/debridement group having the longest duration of hospitalization (14.5 ± 9.8 days). Conclusion: During the acute treatment phase, a significant increase in crush syndrome and wound infection rates, accompanied by a greater need for hemodialysis and prolonged hospitalization, were frequently observed. We hypothesize that the findings of studies on earthquake-related experience could provide a reference for future investigations.