Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, 21287 MD USA.
Department of Orthopaedics, Hospital and Rehabilitation Centre for Disabled Children, Adhikari Gaoun, Urgratara VDC-6, Janagal Kavre Nepal.
World J Emerg Surg. 2017 Feb 10;12:9. doi: 10.1186/s13017-017-0115-8. eCollection 2017.
Earthquakes in developing countries are devastating events. Orthopaedic surgeons play a key role in treating earthquake-related injuries to the extremities. We describe orthopaedic injury epidemiology to help guide response planning for earthquake-related disasters.
Several databases were searched for articles reporting primary injury after major earthquakes from 1970 to June 2016. We used the following key words: "earthquake" AND "fracture" AND "injury" AND "orthopedic" AND "treatment" AND "epidemiology." The initial search returned 528 articles with 253 excluded duplicates. The remaining 275 articles were screened using inclusion criteria, of which the main one was the description of precise anatomic location of fracture. This yielded 17 articles from which we analyzed the ratio of orthopaedic to nonorthopaedic injuries; orthopaedic injury location, type, and frequency; fracture injury characteristics (open vs. closed, single vs. multiple, and simple vs. comminuted); and first-line treatments.
Most injuries requiring treatment after earthquakes (87%) were orthopaedic in nature. Nearly two-thirds of these injuries (65%) were fractures. The most common fracture locations were the tibia/fibula (27%), femur (17%), and foot/ankle (16%). Forty-two percent were multiple fractures, 22% were open, and 16% were comminuted. The most common treatment for orthopaedic injuries in the setting of earthquakes was debridement (33%).
Orthopaedic surgeons play a critical role after earthquake disasters in the developing world. A strong understanding of orthopaedic injury epidemiology and treatment is critical to providing effective preparation and assistance in future earthquake disasters.
发展中国家的地震是毁灭性的事件。矫形外科医生在治疗与地震有关的四肢损伤方面发挥着关键作用。我们描述矫形损伤流行病学，以帮助指导与地震有关的灾害的应对规划。
从 1970 年至 2016 年 6 月，我们搜索了几个数据库，以获取报告主要地震后原发性损伤的文章。我们使用了以下关键词：“地震”和“骨折”和“损伤”和“矫形”和“治疗”和“流行病学”。初始搜索返回了 528 篇文章，其中 253 篇是重复的。使用纳入标准筛选了剩余的 275 篇文章，主要标准是描述骨折的确切解剖位置。从这 17 篇文章中，我们分析了矫形与非矫形损伤的比例；矫形损伤的位置、类型和频率；骨折损伤的特征（开放性与闭合性、单一与多发性、简单与粉碎性）；以及一线治疗方法。
大多数需要治疗的地震后损伤（87%）是矫形性的。其中近三分之二（65%）是骨折。最常见的骨折部位是胫骨/腓骨（27%）、股骨（17%）和足/踝（16%）。42%是多发性骨折，22%是开放性骨折，16%是粉碎性骨折。地震环境中矫形损伤的最常见治疗方法是清创术（33%）。
在发展中国家的地震灾害后，矫形外科医生发挥着至关重要的作用。对矫形损伤流行病学和治疗的深入了解对于在未来的地震灾害中提供有效的准备和援助至关重要。
