ljequinox (ljequinox) wrote in little_details,
ljequinox
ljequinox
little_details

Crush injury / nerve damage in knee and lower leg

Fandom: Hunger Games

Setting: snowy mountainous arena, sub-freezing temperatures, almost 50 years before the events of the HG series

Medicine: futuristic/sci-fi, though not quite as advanced as the time period of the series; even within the series they couldn't repair damaged nerves/tissue from a tourniquet, for example, which required amputating the limb.

Basically I've got a general idea of the injury I want, and I know what I want the lingering effects to be 20 years later. What I'm not so sure about is how to stitch the two together (pun intended).

Injury:
Character is a 15-year-old male tribute in the 27th Hunger Games. He gets swept up in an avalanche and only escapes plunging over the edge of a canyon because his left leg gets pinned between a small tree and a large rock / small boulder. His leg remains pinned at/just below the knee for maybe an hour(??) before he gets it free. After that it's maybe 3 to 5-ish more days in the arena before he has access to the high-tech medicine of the Capitol. (A couple days after the injury a fellow tribute with rudimentary medical knowledge does very briefly attempt some first aid, but she's almost immediately interrupted.)

20 years later:
Able to walk without any kind of crutch/cane/brace (he'd probably be better off with something like that, but he's too stubborn), but he's got a limp. There is permanent nerve damage and probably intermittent pain/tingling/numbness; he has good days and bad days. He generally favors the leg when walking and standing, and avoids running if at all possible, not that he's super athletic in the first place. Prolonged enough use of his leg will necessitate bed/chair-rest for a day or so.

Questions for immediately after the injury occurs, before access to real medicine:

(First off, if anything in my initial parameters seems super far-fetched or unrealistic, please let me know.)

-Theoretically, what amount of time could his leg be pinned (cut-off circulation, etc.) to cause that kind of nerve damage? How soon would blood flow have to be restored to prevent significant muscle death, paralysis, or anything else that might necessitate amputation?

-I know pretty little about compartment syndrome, but could that realistically result in the kind of nerve damage and permanent effects I described?

-The initial force wasn't enough to completely shatter his leg or anything, but I'm assuming some fracturing/dislocating of his knee and/or tibia would be pretty likely?

-Assuming nerve damage + possible compartment syndrome + sprain/fractures, what kind of sensation would he likely be feeling in the leg? What might the leg itself look like? (abrasions, bruising, discoloration, deformed-ness, etc.)

-Any likelihood of bearing weight, with/without some kind of makeshift crutch?

-How would frostbite come into play? Extra risk with the lack of blood flow and loss of sensation, or would the risk be about the same as normal once circulation was restored?

-What first aid would/could be attempted, in the freezing wilderness with maybe only a basic first aid kit?


Search terms:
I've tried various permutations of "nerve damage knee", "nerve damage trapped leg", "pinned leg injury", "trapped leg injury", "crush injury knee", "crush injury lower leg", etc., but most results were for nerve disorders or rather gruesome descriptions and pictures from industrial machinery accidents. I did find this forum thread discussing leg nerve damage from herniated discs, though I'm not sure how comparable those experiences would be to my character.


Any suggestions / feedback will be greatly appreciated! Thanks in advance! :)
Tags: ~medicine: injuries (misc), ~medicine: injuries to order, ~wilderness survival
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