Crush injury to the lower limbs. Treatment of the local injury.

We treated fifteen patients who had been trapped under the masonry of collapsed buildings for various periods of time. In one group of patients who had been buried for twelve hours, treatment commenced only twenty-four hours after the injury, and the other group was treated more promptly. In the second group, the success of forced diuresis and alkalinization of the urine in preventing the renal complications of the crush syndrome was evident. A reassessment of the treatment of the local lesion was made and a scheme of treatment is proposed. The injury is essentially closed, and incomplete excision of the necrotic muscle is fraught with risk. Local rigor in the affected muscles is important.