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Earthquake-Related Orthopedic Injuries in Adult Population: A Systematic Review

Published online by Cambridge University Press:  30 January 2017

Michelangelo Bortolin ,
Ilaria Morelli ,
Amalia Voskanyan; ,
Nina R. Joyce  and
Gregory R. Ciottone
Michelangelo Bortolin*
Affiliation:
Emergency Medical Services, Torino, Grugliasco, Italy Vita-Salute San Raffaele University, Milan, Italy Beth Israel Deaconess Medical Center (BIDMC), Boston, MassachusettsUSA
Ilaria Morelli
Affiliation:
Vita-Salute San Raffaele University, Milan, Italy
Amalia Voskanyan;
Affiliation:
Beth Israel Deaconess Medical Center (BIDMC), Boston, MassachusettsUSA
Nina R. Joyce
Affiliation:
Beth Israel Deaconess Medical Center (BIDMC), Boston, MassachusettsUSA Brown University Department of Epidemiology, Providence, Rhode IslandUSA
Gregory R. Ciottone
Affiliation:
Beth Israel Deaconess Medical Center (BIDMC), Boston, MassachusettsUSA Emergency Medicine, Harvard Medical School, Boston, MassachusettsUSA
*
Correspondence: Michelangelo Bortolin, MD EMS 118, Torino (Italy) Vita-Salute San Raffaele University (Italy) BIDMC, Boston, Massachusetts (USA) E-mail: [email protected]
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Abstract

Introduction

Earthquake-related trauma results in crush injuries and bony- and soft-tissue trauma. There are no systematic reviews analyzing the typical injury patterns and treatments in “Mega-Mass-Casualty” earthquakes. The characterization of an injury pattern specific to disaster type, be it natural or manmade, is imperative to build an effective disaster preparedness and response system.

Methods

The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search strategy was developed to identify all publications relating to earthquakes and the orthopedic treatment in adult patients. The following databases were searched: PubMed (Medline; US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA), Ovid (Ovid Technologies; New York, New York USA), Web of Science (Thomson Reuters; New York, New York USA), and The Cochrane Library (The Cochrane Collaboration; Oxford, United Kingdom).

Results

The searches identified 4,704 articles: 4,445 after duplicates were removed. The papers were screened for title and abstract and 65 out of those were selected for full-text analysis. The quality of data does not permit a standard-of-care (SOC) to be defined. Scarcity and poor quality of the data collected also may suggest a low level of accountability of the activity of the international hospital teams. Qualitatively, it is possible to define that there are more open fractures during daytime hours than at night. Excluding data about open and closed fractures, for all types of injuries, the results underline that the higher the impact of the earthquake, as measured by Richter Magnitude Scale (RMS), the higher is the number of injuries.

Discussion

Regarding orthopedic injuries during earthquakes, special attention must be paid to the management of the lower limbs most frequently injured. Spinal cord involvement following spine fractures is an important issue: this underlines how a neurosurgeon on a disaster team could be an important asset during the response. Conservative treatment for fractures, when possible, should be encouraged in a disaster setting. Regarding amputation, it is important to underline how the response and the quality of health care delivered is different from one team to another. This study shows how important it is to improve, and to require, the accountability of international disaster teams in terms of type and quality of health care delivered, and to standardize the data collection.

BortolinM, MorelliI, VoskanyanA, JoyceNR, CiottoneGR. Earthquake-Related Orthopedic Injuries in Adult Population: A Systematic Review. Prehosp Disaster Med. 2017;32(2):201–208.

Keywords

disasterearthquakeinjuryorthopedicreview
Type
Comprehensive Reviews
Information
Prehospital and Disaster Medicine , Volume 32 , Issue 2 , April 2017 , pp. 201 - 208
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest: none

References

1. United States Geological Survey (USGS; Reston, Virginia USA) Earthquake Hazards Program. Earthquakes with 50,000 or More Deaths 2012. https://earthquake.usgs.gov/earthquakes/world/world_deaths.php. Accessed March 28, 2016.Google Scholar
2. United States Geological Survey (USGS; Reston, Virginia USA) Earthquake Hazards Program. Largest and Deadliest Earthquakes by Year 1990-2011. Vol 20142012. https://earthquake.usgs.gov/earthquakes/world/10_largest_world.php. Accessed March 28, 2016.Google Scholar
3. Violante, DA, Kivlehan, S, Flores, R. View from the ground. NYC Medics witnessed the aftermath of the Haitian earthquake first hand. Here’s what others hoping to help after international disasters should know. EMS Mag. 2010;39(4):29-32.Google Scholar
4. Moher, D, Liberati, A, Tetzlaff, J, Altman, D, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.CrossRefGoogle ScholarPubMed
5. Bar-On, E, Lebel, E, Kreiss, Y, et al. Orthopedic management in a mega mass casualty situation. The Israel Defence Forces Field Hospital in Haiti following the January 2010 earthquake. Injury. 2011;42:1053-1059.CrossRefGoogle Scholar
6. Liu, L, Tang, X, Pei, F, et al. Treatment for 332 cases of lower leg fracture in “5.12” Wenchuan earthquake. Chin J Traumatol. 2010;13(1):10-14.Google Scholar
7. Guner, S, Guner, SI, Isik, Y, et al. Review of Van earthquakes form an orthopedic perspective: a multicenter retrospective study. Int Orthop. 2013;37(1):119-124.Google Scholar
8. Kaim Khani, GM, Baig, A, Humail, M, Memon, M, Quarashi, MA. Musculoskeletal injuries among victims of the Battagram, Pakistan earthquake in October 2005. Prehosp Disaster Med. 2012;27(5):489-491.CrossRefGoogle ScholarPubMed
9. Görmeli, G, Görmeli, CA, Güner, S, Ceylan, MF, Dursun, R. The clinical profile of musculoskeletal injuries associated with the 2011 Van earthquake in Turkey. Eklem Hastalik Cerrahisi. 2012;23(2):68-71.Google Scholar
10. Li, T, Jiang, X, Chen, H, Yang, Z, Wang, X, Wang, M. Orthopedic injury analysis in the 2010 Yushu, China earthquake. Injury. 2012;43(6):886-890.Google Scholar
11. Phalkey, R, Reinhardt, JD, Marx, M. Injury epidemiology after the 2001 Gujarat earthquake in India: a retrospective analysis of injuries treated at a rural hospital in the Kutch district immediately after the disaster. Glob Health Action. 2011;4:7196.Google Scholar
12. Dai, ZY, Li, Y, Lu, MP, Chen, L, Jiang, DM. Clinical profile of musculoskeletal injuries associated with the 2008 Wenchuan earthquake in China. Ulus Travma Acil Cerrahi Derg. 2010;16(6):503-507.Google Scholar
13. Rajpura, A, Boutros, I, Khan, T, Khan, SA. Pakistan earthquake: experiences of a multi-disciplinary surgical team. Prehosp Disaster Med. 2010;25(4):361-367.Google Scholar
14. Emami, M, Tavakoli, A, Alemzadeh, H, et al. Strategies in evaluation and management of Bam earthquake victims. Prehosp Disaster Med. 2005;20(5):327-330.Google Scholar
15. Min, L, Tu, CQ, Liu, L, et al. Management of limb fractures in a teaching hospital: comparison between Wenchuan and Yushu earthquakes. Chin J Traumatol. 2013;16(1):16-21.Google Scholar
16. Bai, XD, Liu, XH. Retrospective analysis: the earthquake-injured patients in Barakott of Pakistan. Chin J Traumatol. 2009;12(2):122-124.Google Scholar
17. Mulvey, JM, Awan, SU, Qadri, AA, Maqsood, MA. Profile of injuries arising from the 2005 Kashmir earthquake: the first 72 h. Injury. 2008;39(5):554-560.Google Scholar
18. Benner, P, Stephan, J, Renard, A, et al. Role of the French rescue teams in Diquini Hospital: Port-au-Prince, January 2010. Prehosp Disaster Med. 2012;27(6):615-619.Google Scholar
19. Elmi, A, Ganjpour Sales, J, Tabrizi, A, Soleimanpour, J, Mohseni, MA. Orthopedic injuries following the East Azerbaijan earthquake. Trauma Mon. 2013;18(1):3-7.Google Scholar
20. Teicher, CL, Alberti, K PK, Elder, G, Baron, E, Herard, P. Médecins sans Frontières experience in orthopedic surgery in post-earthquake Haiti in 2010. Prehosp Disaster Med. 2014;29(1):21-26.CrossRefGoogle Scholar
21. Tahmasebi, MN, Kiani, K, Mazlouman, SJ, et al. Musculoskeletal injuries associated with earthquake. A report of injuries of Iran’s December 26, 2003 Bam earthquake casualties managed in tertiary referral centers. Injury. 2005;36(1):27-32.Google ScholarPubMed
22. Pang, HN, Lim, W, Chua, WC, Seet, B. Management of musculoskeletal injuries after the 2009 western Sumatra earthquake. J Orthop Surg (Hong Kong). 2011;19(1):3-7.CrossRefGoogle ScholarPubMed
23. Yasin, MA, Malik, SA, Nasreen, G, Safdar, CA. Experience with mass casualties in a subcontinent earthquake. Ulus Travma Acil Cerrahi Derg. 2009;15(5):487-492.Google Scholar
24. Mohebbi, HA, Mehrvarz, S, Saghafinia, M, et al. Earthquake related injuries: assessment of 854 victims of the 2003 Bam disaster transported to tertiary referral hospitals. Prehosp Disaster Med. 2008;23(6):510-515.CrossRefGoogle ScholarPubMed
25. Chen, R, Song, Y, Kong, Q, Zhou, C, Liu, L. Analysis of 78 patients with spinal injuries in the 2008 Sichuan, China, earthquake. Orthopedics. 32(5):322.Google Scholar
26. Zhao, JN, Wang, R, Wang, BY, et al. Secondary definitive surgery for multiple injuries from Wenchuan earthquake in China. Chin J Traumatol. 2009;12(1):38-40.Google ScholarPubMed
27. Salimi, J, Abbasi, M, Khaji, A, Zargar, M. Analysis of 274 patients with extremity injuries caused by the Bam earthquake. Chin J Traumatol. 2009;12(1):10-13.Google Scholar
28. Lu-Ping, Z, Rodriguez-Llanes, JM, Qi, W, et al. Multiple injuries after earthquakes: a retrospective analysis on 1,871 injured patients from the 2008 Wenchuan earthquake. Crit Care. 2012;16(3):R87.Google Scholar
29. Zhang, JL, He, HC, Lin, HD, et al. Motor function and activities of daily living capacity of patients with fractures sustained during the Wenchuan earthquake. Chin Med J (Engl). 2011;124(10):1504-1507.Google Scholar
30. Qiu, J, Liu, GD, Wang, SX, et al. Analysis of injuries and treatment of 3,401 inpatients in 2008 Wenchuan earthquake--based on Chinese Trauma Databank. Chin J Traumatol. 2010;13(5):297-303.Google Scholar
31. Bozkurt, M, Ocguder, A, Turktas, U, Erdem, M. The evaluation of trauma patients in Turkish Red Crescent Field Hospital following the Pakistan earthquake in 2005. Injury. 2007;38(3):290-297.Google Scholar
32. Li, Y, Pan, F, Li, Y. Analysis of rehabilitation needs, measures taken, and their effectiveness for the wounded following the Wenchuan Earthquake. J Evid Based Med. 2009;2(4):258-264.Google Scholar
33. Fan, Z, Li, A, Lian, B, et al. Injury types of victims in the 12th May 2008 Wenchuan earthquake: analysis of 1,038 patients in Jiangyou City. Eur J Trauma Emerg Surg. 2011;37(1):3-7.CrossRefGoogle Scholar
34. Zhang, L, Zhao, M, Fu, W, et al. Epidemiological analysis of trauma patients following the Lushan earthquake. PLoS One. 2014;9(5):e97416.Google Scholar
35. Lee, CYL, Riley, JM. “Public Health and Disasters.” In: GR C, (ed). Disaster Medicine. Third ed. Amsterdam, Netherlands: Mosby Elsevier; 2006: 7.Google Scholar
36. Bar-On, E, Lebel, E, Blumberg, N, Sagi, R, Kreiss, Y, Israel Defense Forces Medical Corps. Pediatric orthopedic injuries following an earthquake: Experience in an acute-phase field hospital. J Trauma Acute Care Surg. 2013;74(2):617-621.Google Scholar
37. Cross, WW 3rd, Swiontkowski, MF. Treatment principles in the management of open fractures. Indian J Orthop. 2008;42(4):377-386.Google ScholarPubMed
38. Pape, HC, Pfeifer, R. Safe definitive orthopedic surgery (SDS): repeated assessment for tapered application of Early Definitive Care and Damage Control? An inclusive view of recent advances in polytrauma management. Injury. 2015;46(1):1-3.CrossRefGoogle ScholarPubMed
39. D’Alleyrand, JCG, O’Toole, RV. The evolution of damage control orthopedics. Current evidence and practical applications of early appropriate care. Orthop Clin N Am. 2013;44(4):499-507.Google Scholar
40. Caba-Doussoux, P, Leon-Baltasar, JL, Garcia-Fuentes, C, Resines-Erasun, C. Damage control orthopedics in severe polytrauma with femur fracture. Injury. 2012;43:S42-S46.Google Scholar
41. Ratto, N. Early total care versus damage control: current concepts in the orthopedic care of polytrauma patients. ISRN Orthopedics. 2013;2013.Google Scholar
42. Lichte, P, Kobbe, P, Dombroski, D, Pape, HC. Damage control orthopedics: current evidence. Curr Opin Crit Care. 2012;18(6):647-650.Google Scholar
43. Pape, HC, Hildebrand, F, Pertschy, S, et al. Changes in the management of femoral shaft fractures in polytrauma patients: from early total care to damage control orthopedic surgery. J Trauma. 2002;53(3):452-462.Google Scholar
44. Harwood, PJ, Giannoudis, PV, van Griensven, M, Krettek, C, Pape, HC. Alterations in the systemic inflammatory response after early total care and damage control procedures for femoral shaft fracture in severely injured patients. J Trauma. 2005;58(3):446-452.Google Scholar
45. Taeger, G, Ruchholtz, S, Waydhas, C, Lewan, U, Schmidt, B, Nast-Kolb, D. Damage control orthopedics in patients with multiple injuries is effective, time saving, and safe. J Trauma. 2005;59(2):409-416.Google Scholar
46. Knowlton, LM, Gosney, JE, Chackungal, S, et al. Consensus statements regarding the multi-disciplinary care of limb amputation patients in disasters or humanitarian emergencies: report of the 2011 Humanitarian Action Summit Surgical Working Group on amputations following disasters or conflict. Prehosp Disaster Med. 2011;26(6):438-448.Google Scholar