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

Abstract

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. Bortolin M , Morelli I , Voskanyan A , Joyce NR , Ciottone GR . Earthquake-related orthopedic injuries in adult population: a systematic review. Prehosp Disaster Med. 2017;32(2):201-208.

Nutritional resilience in Nepal following the earthquake of 2015

“…Most studies of earthquake impacts have focused on short-term consequences like mortality [ 30 ] or injury [ 31 , 32 ]. However, there is a small but growing body of evidence studying the effects of earthquakes on nutrition, derived largely from South American contexts.…”

Natural Disasters and Injuries: What Does a Surgeon Need to Know?

“…One reason may be the lack of a common definition of what is an injury. High-magnitude earthquakes might cause more crush injuries and burying than low magnitude [ 35 •]. Building damage is a major cause of death and injury in earthquakes, especially where solid building materials such as concrete are used, and buildings are not adapted to withstand ground motion [ 36 ].…”

“…Spinal column fractures accounted for 17% of the total injuries, and more than 4% of these were spinal injuries, while 10% of fractures involved the pelvic ring. They also found that fracture incidence seemed to correlate with the Richter Magnitude Scale, with a high-energy earthquake causing more fractures [ 35 •].…”

“…Burn injuries are relatively rare, but more common in rural areas of low- and middle-income countries, where basic cooking methods and heating is used. Earthquakes occurring during common cooking times might also increase the burn incidence [ 35 •, 41 ].…”

Earthquakes and their environmental, medical and public health impacts

“…When it is possible, conservative treatment for fractures should be encouraged at disaster site. [26][27][28] Neurosurgical injuries demand correct triage procedures and prompt intervention with appropriate and qualified equipment. This will play a key role in reducing morbidity and mortality.…”