Clinical Features and Outcomes of Orthopaedic Injuries After the Kahramanmaraş Earthquake: a Retrospective Study From a Hospital Located in the Affected Region

Abstract

Background The purpose of this retrospective, single-institutional study was to report the clinical features and outcomes of orthopaedic injuries after the Kahramanmaraş earthquake. Methods An institutional database review was conducted to determine individual causalities among patients admitted to the emergency department of our hospital after the Kahramanmaraş earthquake. Trauma patients referred to orthopaedics and traumatology were identified. Patient records were checked for injury type, fracture site, treatment type (conservative or surgical), surgical technique, and outcome. Diagnosis with crush syndrome and the need for haemodialysis were also noted. Bedside fasciotomy was undertaken based on the urgency of the patient’s condition as well as the availability of the operating theatre. A team consisting of a trauma surgeon, a plastic surgeon, a board-certified physician in infectious disease, a reanimation specialist, a general surgeon and a nephrologist followed up with the patients. Results Within the first 7 days following the earthquake, 265 patients were admitted to the emergency department, and 112 (42.2%) of them were referred to orthopaedics and traumatology. There were 32 (28.5%) patients diagnosed with acute compartment syndrome. Fasciotomy was performed on 43 extremities of 32 patients. Of these extremities, 5 (11.6%) were upper and 38 (88.4%) were lower extremities, and the risk of acute compartment syndrome was significantly higher for lower extremities (5/43 vs. 38/43, respectively; p = 0.001). A significant relationship was found between the absence of diaphyseal fracture in the extremity and the development of acute compartment syndrome (p = 0.0001). The surgeries of 16 (50%) of the patients who underwent fasciotomy were performed in the emergency department. There was no significant difference in terms of complications and outcomes between performing the fasciotomy at the bedside or in the operating theatre (p = 0.456). Conclusions Fasciotomy appears to be a crucial surgical procedure for the care of earthquake causalities. Fasciotomy can be safely performed as a bedside procedure based on the urgency of the patient’s condition as well as the availability of the operating theatre.