Khan S, Neradi D, Unnava N, Jain M, Tripathy SK. Pathophysiology and management of crush syndrome: A narrative review. World J Orthop 2025; 16(4): 104489 [DOI: 10.5312/wjo.v16.i4.104489]
Corresponding Author of This Article
Sujit Kumar Tripathy, Professor, Department of Orthopedics, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar 751019, India. sujitortho@yahoo.co.in
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shahnawaz Khan, Deepak Neradi, Nikhil Unnava, Mantu Jain, Sujit Kumar Tripathy, Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar 751019, India
Author contributions: Khan S, Neradi D, and Unnava N designed the concept, searched the literature, and extracted the data; Khan S and Tripathy SK prepared the manuscript; Jain M and Tripathy SK provided the intellectual content; All authors read the article and approved it for publication.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sujit Kumar Tripathy, Professor, Department of Orthopedics, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar 751019, India. sujitortho@yahoo.co.in
Received: December 23, 2024 Revised: March 19, 2025 Accepted: March 20, 2025 Published online: April 18, 2025 Processing time: 116 Days and 5.6 Hours
Core Tip
Core Tip: Crush syndrome is a life-threatening condition caused by traumatic rhabdomyolysis, resulting in systemic complications, particularly acute kidney injury. Pathophysiologically, muscle damage releases toxins such as myoglobin, potassium, and lactic acid into the bloodstream, leading to renal tubule damage, hyperkalemia-induced cardiac arrhythmias, metabolic acidosis, and coagulopathy. Modern insights highlight the role of ferroptosis, oxidative stress, and macrophage activity in acute kidney injury progression. Management emphasizes early recognition, fluid resuscitation, renal protection, and innovative therapies like antioxidants, hyperbaric oxygen, and erythropoietin. Comprehensive treatment also includes pre-hospital care, electrolyte correction, renal replacement therapy, and long-term rehabilitation to improve outcomes and quality of life.
