Fasciotomy in crush injury resulting from prolonged pressure in an earthquake in Turkey

The authors report on the patients treated in a clinic who were injured in the earthquake that took place in north western part of Turkey in 1999 and was reported to be measured at 7.4 on the Richter scale. This catastrophe killed over 16 000 people while injuring more than 23 000 people. The type of housing was varied and entrapment occurred in single, two or more storey buildings.

35 patients were admitted to the plastic surgery department after the earthquake. The hospital is about 400 km from the disaster site. Although all the transported victims had intravenous lines, few had adequate volume replacement. Sixteen had an urgent fasciotomy at the time of admission. The procedures were performed between 8 and 21 hours after extrication. After fasciotomy, all non-viable muscle content was removed but an attempt was made to retain as much viable muscle as possible.

Amputation was required on four patients (25%). Fasciotomy incisions were closed with skin grafting in eight cases, and with primary closure in four cases.

Prompt fasciotomy in earthquake victims will be both life saving and can prevent some of the severe and dangerous complications after crush syndrome.