Crush Syndrome: Post-Traumatic Anuria

Traumatic shock is thought of as an acute state from which no threatening residues persist. As regards recovery ofrenal function, doubt was cast on this view by reports from the scene of the Messina earthquake and by detailed studies of cases of post-traumatic uremia occurring in the German Army in World War I.¹Crush syndrome was rediscovered, named and studied on a wider scale during the London blitz.²Similar cases have been reported from the accidents of civilian life.³Many others, civil and military, have probably gone undiagnosed because fatal shock and sepsis have probably overshadowed the defect of renal function. Typically, the syndrome is initiated by crush of a limb or occlusion of its arterial supply for several hours. Release from debris or restoration of blood flow is followed by swelling, with whealing at the sites of compression. The limb becomes hard, paralyzed and anesthetic. Loss