Compartment Syndromes ; etiology ; Crush Syndrome ; complications ; Fascia ; Hand Injuries ; complications ; Humans ; Infant, Newborn

OBJECTIVE: To observe the changes of electrocardiogram and serum cardiac troponin I at the early stage of severe crush injury in rats. METHODS: Crush injury was produced in Sprague-Dawley rats. The changes of electrocardiogram were recorded with the standard II, the serum levels of cardiac troponin I were studied by automated chemiluminescence assay. RESULTS: The ST segment elevated considerably after crush injury and lasted 24 h, the levels of serum cTnI were much higher than those of the control groupes after 6 h of injury. CONCLUSION Cardiomyocyte injury was induced in the early phase of crush injury.
Animals ; Crush Syndrome/physiopathology* ; Electrocardiography ; Extremities/injuries* ; Female ; Heart Injuries/physiopathology* ; Male ; Rats ; Rats, Sprague-Dawley ; Troponin I/blood*

Limb trauma is the most common among pediatric victims in earthquake. Compared with traumatic brain injury, which is frequent in earthquake, intracranial injury is rare, but it is the leading cause of death from trauma in earthquake. Thoracoabdominal crush injury, which often causes such crises as visceral hemorrhage, is also one of the main causes of death among pediatric victims in earthquake. Crush syndrome and osteofascial compartment syndrome are often complicated by acute renal failure. Because trauma is emergent in earthquake, the principle of "life-saving first, critical injury priority" should be complied with during on-site rescue. The injured children must be transferred to the medical center as soon as possible. It is essential to treat the critically injured children by multidisciplinary cooperation, and much attention should be paid to prevention of complications, rehabilitation care, and psychological counseling.
Brain Injuries ; therapy ; Child ; China ; epidemiology ; Crush Syndrome ; therapy ; Earthquakes ; Emergency Medical Services ; Humans ; Shock ; therapy ; Soft Tissue Injuries ; therapy ; Wounds and Injuries ; epidemiology ; therapy

OBJECTIVETo explore the therapeutic strategy of hot press injury complicating with blood vessel injury in the upper extremity.

METHODSDecompression procedure was carried out in 8 patients with hot press injury complicating with blood vessel injury in the upper extremities, but the effect was not of satisfactory because there were injuries to brachial, radial and ulnar arteries and also injury to the superficial or deep palmar arch. The blood vessels were repaired with direct anastomosis, anastomosis with flexion of the limb, or transplantation with great saphenous vein, and the wounds were covered with intermediate split-thickness skin graft or pedicled thoraco-abdominal skin flap.

RESULTSOne patient with repair of the brachial artery and intermediate split thickness skin graft received amputation 4 weeks after operation because of lack of soft tissue coverage. The blood supply recovered completely in the other patients, so the affected limbs were saved.

CONCLUSIONPrompt exploration and repair of blood vessel, and coverage of the wound with healthy soft tissue are key procedures for the management of hot press injury complicating with blood vessel injury in the upper extremities.

Adolescent ; Adult ; Arm Injuries ; surgery ; Brachial Artery ; injuries ; Burns ; pathology ; surgery ; Crush Syndrome ; surgery ; Decompression, Surgical ; Female ; Humans ; Male ; Saphenous Vein ; transplantation ; Skin Transplantation ; Wound Healing ; Young Adult

To explore the value of conventional ultrasound combined with shear-wave elastography in the quantitative evaluation of sciatic nerve crush injury in rabbit models. Forty healthy male New Zealand white rabbits were randomly divided into four groups (=10 in each group):three crush injury (CI) groups (2,4,and 8 weeks after crush) and control group (without injury). The thickness and stiffness of the crushed sciatic nerves and denervated triceps surae muscles were measured at different time points and compared with histopathologic parameters. Inter-reader variability was assessed with intraclass correlation coefficients. Compared with the control group,the inner diameters of the sciatic nerves significantly increased in the 2-week CI group [(1.65±0.34) mm (0.97±0.15) mm,=0.00] but recovered to the nearly normal level in the 8-week CI group [(1.12±0.18) mm (0.97±0.15) mm,=0.06];however,compared with control group [(8.75±1.02)kPa],the elastic modulus of the nerves increased significantly in all the CI groups [2-week:(14.77±2.53) kPa;4-week:(19.12±3.46) kPa;and 8-week:(28.39±5.26) kPa;all =0.00];pathologically,massive hyperplasia of collagen fibers were found in the nerve tissues. The thickness of denervated triceps surae muscle decreased gradually,and the elastic modulus decreased 2 weeks after injury but increased gradually in the following 6 weeks;pathologically,massive hyperplasia of collagen fibers and adipocytes infiltration were visible,along with decreased muscle wet-weight ratio and muscle fiber cross-sectional area. The inter-reader agreements were good. Conventional ultrasound combined with shear-wave elastography is feasible for the quantitative evaluation of the morphological and mechanical properties of crushed nerves and denervated muscles.
Animals ; Crush Injuries ; diagnostic imaging ; Elastic Modulus ; Elasticity Imaging Techniques ; Male ; Muscle, Skeletal ; innervation ; pathology ; Rabbits ; Random Allocation ; Sciatic Nerve ; injuries ; Ultrasonography

AIMTo explore the effect of Simvastatin on the regeneration of sciatic nerve with crush injury in rats.

METHODSAnimals were randomized into the following experimental groups: Simvastatin-treated, vehicle and sham-operated groups. Sciatic nerves with crush injury were performed. After surgery, the functional evaluation of nerve recovery, electrophysiologic assessment, histological assessment, serum IL-6 and lipid were performed.

RESULTSThe toe spread index of Simvastatin-treated rats after operation was higher significantly than vehicle rats at 5 d and 8 d (P<0.05). CMAP was higher and NCV was faster (P < 0.05). The serum IL-6 at 5 d of post-operation was significant lower (P < 0.05). Total serum cholesterol of Simvastatin-treated animals was higher than that of other animals (P < 0.05) at 2 weeks of post-operation. The histological analysis showed that the numbers of myelinated axons and the thickness of myelin sheath of Simvastatin-treated crush injury animals at 4 weeks of post-operation were more than that of vehicle animals.

CONCLUSIONThe present study showed that Simvastatin could promote the regeneration of the sciatic nerve after crush injury in rats, partly through inhibiting immune and inflammatory responses and making the balance of serum cholesterol during these processes.

Animals ; Female ; Nerve Crush ; Nerve Regeneration ; drug effects ; physiology ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; drug effects ; injuries ; physiology ; Simvastatin ; pharmacology

Children are the most vulnerable in natural disasters for their poor self-protection ability. Pediatric deaths in earthquakes are mainly due to cardiopulmonary arrest, severe craniocerebral injury, shock, crush syndrome, and multiple organ failure. Priority should be given to centralized, effective treatment for injured children, with multidisciplinary cooperation, and severe cases need to be transferred to the pediatric intensive care unit, thus improving survival and reducing disability.
Acute Lung Injury ; therapy ; Child ; China ; epidemiology ; Crush Syndrome ; therapy ; Disasters ; Earthquakes ; Humans ; Respiratory Insufficiency ; therapy ; Shock ; therapy ; Wounds and Injuries ; epidemiology ; therapy

OBJECTIVETo study the clinical therapeutic effect of antioxidants assistant treatment of extremities crush syndrome (CS)in order to find new therapy.

METHODSTwenty-one male patients (aged from 24 to 48 years, mean 36 years) were treated with the next antioxidants in early stage: (1) 20% Mannitol 250 ml intravenous drip in 30 minutes (one time per 6 to 8 h). (2) Sodium aescinate 20 mg, Salvia Miltiorrhiza 20 ml were dissolved respectively in isotonic saline or 5% glucose 200 ml and dripped by intravenous drip (50 to 60 drips per minute). The drugs were used for 5 to 7 days (one time per day). Basifying urine, keeping the nagative liquid banlance and electrolyte banlance, preventing infection and hold out treatment were done. When the pressure of muscular osteofascial compartment was more than 30 mmHg, deep fasia was cut to decompress timely and the above-mentioned drugs were continuously applied for patients.

RESULTSMyoglobin urine of 21 cases died out after 2 to 3 days, of them, 13 cases were performed to decompress. After open decompression, 2 cases suffered from amputation because of long time of ischemia, 2 cases took place slight dysfunction of lower limbs, one hand had ischemia muscular contracture in 1 case and one foot down-vertical in 1 case. After followed-up of 8 months to 1 year, according to the function standard, the result were excellent in 8 cases, good in 7 cases, fair in 2 cases, poor in 4 cases. The excellent and good rate was about 71.4% (15/21).

CONCLUSIONAfter extremities crushed for long time, application of antioxidents as early as possible can decrease significantly the incidence and invalidity rate of CS.

Adult ; Antioxidants ; administration & dosage ; therapeutic use ; Crush Syndrome ; complications ; drug therapy ; physiopathology ; urine ; Extremities ; injuries ; Humans ; Male ; Middle Aged ; Myoglobinuria ; complications ; urine ; Young Adult

OBJECTIVE: To study the pathological morphological changes for diagnosing the cause of death of extensive soft tissue injury or crush syndrome. METHODS: The tissues were stained by HE and IHC. RESULTS: (1) The Mb positive rate was 60%, 75%, 95% respectively. (2) Both the HSP70 positive rate of hearts and brains were 90%. CONCLUSION (1) The animal model of broad soft tissue injury was established. (2) Accumulated the pathological morphological data for diagnosing the cause of death of extensive soft tissue injury or crush syndrome.
Animals ; Cause of Death ; Crush Syndrome/pathology* ; Forensic Medicine ; HSP70 Heat-Shock Proteins/metabolism* ; Kidney/pathology* ; Myocardium/pathology* ; Myoglobin/metabolism* ; Rats ; Rats, Sprague-Dawley ; Soft Tissue Injuries/pathology*

OBJECTIVE: To evaluate the effectiveness of neurovascular staghorn flap for repairing defects in fingertips. METHODS: Between August 2019 and October 2021, a total of 15 fingertips defects were repaired with neurovascular staghorn flap. There were 8 males and 7 females with an average age of 44 years (range, 28-65 years). The causes of injury included 8 cases of machine crush injury, 4 cases of heavy object crush injury, and 3 cases of cutting injury. There were 1 case of thumb, 5 cases of index finger, 6 cases of middle finger, 2 cases of ring finger, and 1 case of little finger. There were 12 cases in emergency, and 3 cases with finger tip necrosis after trauma suture. Bone and tendon exposed in all cases. The range of fingertip defect was 1.2 cm×0.8 cm to 1.8 cm×1.5 cm, and the range of skin flap was 2.0 cm×1.5 cm to 2.5 cm×2.0 cm. The donor site was sutured directly. RESULTS: All flaps survived without infection or necrosis, and the incisions healed by first intention. All patients were followed up 6-12 months, with an average of 10 months. At last follow-up, the appearance of the flap was satisfactory, the wear resistance was good, the color was similar to the skin of the finger pulp, and there was no swelling; the two-point discrimination of the flap was 3-5 mm. One patient had linear scar contracture on the palmar side with slight limitation of flexion and extension, which had little effect on the function; the other patients had no obvious scar contracture, good flexion and extension of the fingers, and no dysfunction. The finger function was evaluated according to the total range of motion (TAM) system of the Hand Surgery Society of Chinese Medical Association, and excellent results were obtained in 13 cases and good results in 2 cases. CONCLUSION The neurovascular staghorn flap is a simple and reliable method to repair fingertip defect. The flap has a good fit with the wound without wasting skin. The appearance and function of the finger are satisfactory after operation.
Adult ; Female ; Humans ; Male ; Cicatrix/surgery* ; Contracture/surgery* ; Crush Injuries/surgery* ; Finger Injuries/surgery* ; Plastic Surgery Procedures ; Skin Transplantation/methods* ; Soft Tissue Injuries/surgery* ; Treatment Outcome ; Middle Aged ; Aged