Sahin Adem, Agar Anıl, Hancerli Cafer Ozgur, Kilic Bulent, Gulabi Deniz, Erturk Cemil
Orthopaedics and Traumatology, Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, TUR.
Orthopaedics and Traumatology, Saglik Bilimleri University, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR.
Cureus. 2021 Feb 13;13(2):e13323. doi: 10.7759/cureus.13323.
Aim This study aims to analyze the spectrum, management, and outcome of Syrian refugees' fracture over four-year period, highlighting challenges in management and follow-up. Methods This was a retrospective review of Syrian refugee patients operated for fractures at our centre from January 2015 to January 2019. The patients were evaluated for age, gender, mechanism of injury, location and type of fracture, presence of accompanying injuries, surgical technique, complications, mortality and morbidity. The comparison of complications and postop outpatient clinic controls between Turkish citizens and Syrian refugees were also evaluated. Results The study included a total of 455 patients comprising 281 adults (202 males, 79 females) with a mean (SD) age of 41.1 (19.3) years and 174 children with a mean age of 8.8 (4.9) years. The trauma mechanism was most commonly fall in both adult and pediatric patients (86.6% / 73.5%). Whilst lower limb fractures were more common in adults (73.7%), upper limb fractures were more common in children (63.4%). The presence of accompanying trauma was determined in 21 (7.5%) adults and 10 (5.7%) children. Multiple fractures were determined in 12 (4.3%) adults and eight (4.6%) children. Plate fixation (PF) was most used in 137 (48.8%) adult patients and K-wire augmentation was used in 75 (43.1%) pediatric patients. Out of the 455 patients, 41 (14.6%) adults and 13 (7.3%) children developed complications. Whilst three adult patients were died during follow-up, no deaths were recorded in the pediatric patients. Complication rate was 54/455 in Syrian refugees and 32/455 in citizens. It was observed that the complication was significantly higher in immigrants (p: 0.017). Sixty-five (14.2%) Syrian immigrants did not come to the outpatient clinic control at all or once, while this rate was 29/455 (6.3%) for Turkish citizens (p = 0.012). Conclusion Inadequate living conditions and lack of communication faced by refugees reduce the rate of patient follow-up and negatively affect the results of orthopedic trauma.
目的 本研究旨在分析四年期间叙利亚难民骨折的谱系、治疗及结果，突出治疗和随访中的挑战。方法 这是一项对2015年1月至2019年1月在我们中心接受骨折手术的叙利亚难民患者的回顾性研究。对患者的年龄、性别、受伤机制、骨折部位和类型、伴随损伤情况、手术技术、并发症、死亡率和发病率进行评估。还评估了土耳其公民和叙利亚难民之间并发症及术后门诊复查情况的比较。结果 该研究共纳入455例患者，其中包括281例成年人（202例男性，79例女性），平均（标准差）年龄为41.1（19.3）岁，以及174例儿童，平均年龄为8.8（4.9）岁。在成人和儿童患者中，创伤机制最常见的都是跌倒（86.6% / 73.5%）。虽然下肢骨折在成年人中更常见（73.7%），而上肢骨折在儿童中更常见（63.4%）。在21例（7.5%）成年人和10例（5.7%）儿童中发现有伴随创伤。在12例（4.3%）成年人和8例（4.6%）儿童中发现有多发性骨折。钢板固定（PF）在137例（48.8%）成年患者中使用最多，克氏针增强术在75例（43.1%）儿童患者中使用。在455例患者中，41例（14.6%）成年人和13例（7.3%）儿童出现并发症。在随访期间，3例成年患者死亡，儿童患者无死亡记录。叙利亚难民的并发症发生率为54/455，公民为32/455。观察到移民中的并发症明显更高（p：0.017）。65例（14.2%）叙利亚移民根本没有或只来门诊复查过一次，而土耳其公民的这一比例为29/455（6.3%）（p = 0.012）。结论 难民面临的生活条件不足和沟通不畅降低了患者随访率，并对骨科创伤的治疗结果产生负面影响。
