Double compression of the ulnar nerve, including Guyon's canal syndrome associated with cubital tunnel syndrome caused by the anconeus epitrochlearis muscle, is a very rare condition. We present a case of double crush syndrome of the ulnar nerve at the wrist and elbow in a 55-year-old man, as well as a brief review of the literature. Although electrodiagnostic findings were consistent with an ulnar nerve lesion only at the elbow, ultrasonography revealed a ganglion compressing the ulnar nerve at the hypothenar area and the anconeus epitrochlearis muscle lying in the cubital tunnel. Careful physical examination and ultrasound assessment of the elbow and wrist confirmed the clinical diagnosis prior to surgery.
Crush Syndrome* ; Cubital Tunnel Syndrome ; Deception ; Diagnosis* ; Elbow ; Ganglion Cysts* ; Humans ; Middle Aged ; Physical Examination ; Ulnar Nerve* ; Ultrasonography* ; Wrist

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

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

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 analyze the results of clinical and bacteriological examinations in patients with crush syndrome who suffered infectious complications after an earthquake in Sichuan, China.

METHODSA total of 313 bacteriological samples among 147 patients with crush syndrome were collected. Infectious complications, results of microbiological examinations, potential risk factors of infection and mortality were analyzed statistically.

RESULTSIn the obtained database, 112 out of the 147 (75.7%) patients had infectious complications, in which, wound infection, pulmonary infection, and sepsis were most common. The time under the rubble and the time from injury to treatment were related to the occurrence of wound infection (P equal to 0.013, odds ratio 2.25; P equal to 0.017, odds ratio 2.31). Sepsis and wound infection were more common in patients who underwent fasciotomy or amputation than in those who did not (P equal to 0.001).

CONCLUSIONQuick rescue and injury treatment can decrease the infection risk in crush syndrome patients. It is better to obtain microorganic proofs before applying antibiotics, and bacteriological and drug sensitivity data should be taken into account, especially considering that most of these infections are hospital-acquired and drug resistance. Emphasizing the accuracy and efficiency of wound management in emergency situations, cautiously assessing the indications for fasciotomy to avoid open wounds from unnecessary osteofascial compartment decompression incisions may decrease the incidence of infection and ameliorate the prognosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacterial Infections ; etiology ; Child ; Child, Preschool ; China ; Crush Syndrome ; complications ; microbiology ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Risk Factors

According to the needs of clinical study about the treatment for the crush injury, a special experimental apparatus was developed for the small animal crush injury. There are kinds of characters for this conductor, that is the apparatus was simple designed and can be easily used and the extruding time and weight can be exactly controlled.
Animal Use Alternatives ; instrumentation ; Animals ; Crush Syndrome ; Disease Models, Animal ; Equipment Design

Adolescent ; Adult ; Amputation ; Crush Syndrome ; pathology ; surgery ; Fasciotomy ; Female ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Young Adult

To review the challenges and countermeasures in the hospital care for Wenchuan earthquake casualties and draw lessons for the protective response in the future. Medical records and laboratory findings of the victims admitted in West China Hospital (WCH) were retrospectively analyzed. Related data were compared between beforemath and aftermath of the earthquake and between WCH and frontier county hospitals. One thousand and thirty-one earthquake survivors were hospitalized, 1 358 victims underwent surgery and 142 victims were transferred to intensive care unit. The incidence of infection, crush syndrome and multiple organ dysfunction syndrome (MODS) was 39.6%, 20.7% and 2.3% respectively. Wound classification showed that the incidence of extremity damage was 72%, while the incidence of chest trauma, abdominal trauma and brain trauma was less than 10% respectively. Isolating rates of environmental pathogens were increased in the aftermath of earthquake, and the spectrum of the pathogens and related antibiotic sensitivities were quite different from those in the beforemath of earthquake. The social economic and population conditions in the earthquake-stricken areas affected the composition of the victims and the geographic features restricted the efficiency of rescue. Trauma-induced MODS, crush syndrome and severe infections all constituted the dilemma for the hospital care, to resolve whether the multidiscipline team work was proved to be an optimizing choice. For a more effective disaster protective response in the future, the study on rescue plan and the ladder therapies for massive casualties should be potentiated.
Adolescent ; Adult ; Aged ; Bacterial Infections ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Communicable Disease Control ; Crush Syndrome ; epidemiology ; Earthquakes ; Female ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Multiple Organ Failure ; epidemiology ; Rescue Work ; Young Adult

BACKGROUNDOn May 12, 2008, a major earthquake hit Wenchuan County in Sichuan Province of China. The number of cases of crush injury following this event was high. Ultrasonic appearance of rhabdomyolysis (RM) caused by crush injury in the Wenchuan earthquake was observed to evaluate the diagnostic value of ultrasound for detection of rhabdomyolysis.

METHODSWe analyzed clinical and ultrasonic manifestations of 50 cases of RM and 18 cases of RM with osteofascial compartment syndrome (OCS). All cases were caused by crush injury in the Wenchuan earthquake. For these RM patients, we also evaluated the correlations between creatine kinase (CK) and the scope of the muscle lesions as observed by ultrasound.

RESULTSThere were differences in clinical symptoms, physical signs and ultrasonic appearance between the two groups of patients. The ultrasonic characteristics of the RM were as follows: the striated muscle in the lesions thickened with good overall continuity, and the muscle texture was vague; the strength of the echo was uneven and the echo was cloudy or ground glass-like. Liquid dark zones appeared between muscles and were spindle-like or irregular in shape. There were no blood flow signals in the liquid dark areas. The volume of the striated muscle increased in patients with OCS; the fascia wrapping the muscle showed arched protrusions and significant displacement. The flow velocity of the distal arteries decreased and the spectrum was abnormal. The muscle lesion scope of RM group and RM and OCS group was (7.8 +/- 2.0) cm and (13.6 +/- 3.1) cm, respectively. The correlation coefficient (r) between the muscle lesion scope and the CK was 0.681 for the RM group (P < 0.05) and 0.516 for the RM and OCS group (P < 0.05).

CONCLUSIONSThe ultrasonogram of RM has characteristic manifestations and can provide important information for clinical diagnosis and treatment of rhabdomyolysis.

Adolescent ; Adult ; China ; Compartment Syndromes ; diagnostic imaging ; Crush Syndrome ; diagnostic imaging ; Earthquakes ; Female ; Humans ; Male ; Rhabdomyolysis ; diagnostic imaging ; Ultrasonography ; Young Adult

Acute Kidney Injury ; physiopathology ; Adolescent ; Cardiomyopathies ; pathology ; Crush Syndrome ; physiopathology ; Earthquakes ; Humans ; Male