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Updated: Aug 19, 2026

Induction and Assessment of Exertional Skeletal Muscle Damage in Humans
Published on: December 11, 2016
Crush syndrome: estimating skeletal muscle damage by the rule of thirds
1Community Rescue Service, Inc, Hagerstown, MD, USA.
Abstract:
Since the early 1900s, CI and CS have been observed and reported. However, there has not been a method to rapidly determine the severity of CS based on the amount of SM damaged as the result of high-pressure forces exerted on the tissue. The amount of SM involved in the CI is directly proportional to the severity of the resulting CS. The severity of the CS dictates the level and complexity of care needed to best ensure patient survivability. Unlike surface burn injuries, where the "rule of nines" or the "rule of palm" are used to estimate the percentage of surface area involved, no such method has ever been presented for use in CS. In fact, there has been an attempt to use the "rule of nines" in CS patients. In developing a method to estimate percentage of SM involved in CS, it is hoped that retrospective studies can be performed to generate a workable model for treatment of CS patients.

