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.