Surgical management of closed crush injury-induced compartment syndrome after earthquakes in resource-scarce settings
The use of fasciotomy to treat crush injury induced compartment syndrome is controversial. Conservative treatment should be considered for patients with compartment syndrome presenting late, 48 to 72 hours after onset of symptoms, and amputation should be used only as a last resort.
Crush injuries are reportedly the second most common cause of death after earthquakes. Crush injuries of extremities can lead to compartment syndrome, in which raised pressure within the fascial compartment compromise circulation and function of tissues. Untreated compartment syndromes may lead to amputations and can be lethal. In earthquake-ravaged resource scarce countries, treating compartment syndrome is often complicated by limited resources and late arrival of foreign surgical relief. Consequently, surgery must be adapted to this context requiring specific knowledge and experience.