Trauma is one of the leading causes of rhabdomyolysis. Acute renal failure occurs in about two thirds of cases of rhabdomyolysis. If the treatment is instituted soon after the diagnosis, prognosis improves markedly. The treatment primarily includes hydration, correction of electrolyte abnormalities and probable surgical management of compartment syndrome and crush injury. The decision about the amputation depends on a clinical score called, Mangled Extremity Severity Score (MESS). This scoring system is based on the degree of skeletal / soft tissue injury, rating of blood pressure, pulse and age. The higher the score, the higher is the predictive value of requirement for amputation. Please discuss with the surgical team about this. Also, please involve a nephrologist in taking care of your friend's son for management of hydration and electrolyte abnormalities in the setting of acute renal failure.