Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Ramón y Cajal, M-607, 9, 100, 28034, Madrid, Spain.
Eur J Trauma Emerg Surg. 2023 Dec;49(6):2599-2603. doi: 10.1007/s00068-023-02345-2. Epub 2023 Aug 14.
Trauma secondary to extreme weather events may heavily impact the normal activity of orthopaedic surgery departments, especially in places not prepared to deal with them. The Filomena snowstorm, which happened in January 2021, has been one of the greatest snowstorms ever in Spain. During it, the constant influx of trauma patients made the Orthopaedic Emergencies Department (OED) to collapse. The primary objective of this study was to describe the orthopaedic injuries and changes in fracture's epidemiology observed during this exceptional period. Secondary objectives were to analyse the collected variables in order to minimize the future impact of these unexpected extreme weather events.
Retrospective cohort study between patients that came to the OED during the snowstorm (Filomena group) and those who came on the same period of the previous year (Control group). The following data were collected: age, sex, injury location, injury mechanism, diagnosis, AO/OTA fracture classification, treatment type (conservative vs surgical) and delay to surgical treatment.
A total of 1237 patients were included in total, 655 patients from the Filomena group and 582 from the Control group. One in two patients in the Filomena group sustained a fracture (50.7% vs 23.2%). The most frequent diagnosis on the Filomena group was distal radius fracture (16.2%), five times more frequent than in the Control group (3.4%). A significant increment was also observed in the incidence of ankle (21.7%) and proximal humerus (33%) fractures. In Filomena, surgically treated fractures increased by 168%, being more severe, as C-type fractures were more prevalent (23% vs 13%). Mean delay to surgery was 6.78 days during the snowstorm.
Unexpected snowstorms entail an exponential rise in orthopaedic care demand and OED pressures. A significant increment in orthopaedic trauma surgery, up to 168% more, particularly distal radius, proximal humerus and ankle fractures it is to be expected, which will imply elective surgery cancellation, damaging patients and increasing costs.
极端天气事件引发的创伤可能会严重影响矫形外科部门的正常活动，尤其是在没有准备应对这些事件的地方。2021 年 1 月发生的费利蒙娜暴风雪是西班牙有记录以来最大的暴风雪之一。在此期间，创伤患者不断涌入，导致骨科急诊室（OED）不堪重负。本研究的主要目的是描述在此特殊时期观察到的骨科损伤和骨折流行病学变化。次要目标是分析收集到的变量，以尽量减少这些意外极端天气事件的未来影响。
回顾性队列研究，纳入暴风雪期间（费利蒙娜组）来 OED 的患者和同年同期（对照组）来 OED 的患者。收集的数据包括：年龄、性别、损伤部位、损伤机制、诊断、AO/OTA 骨折分类、治疗类型（保守治疗与手术治疗）和手术治疗延迟。
共纳入 1237 例患者，费利蒙娜组 655 例，对照组 582 例。费利蒙娜组中有一半以上的患者发生骨折（50.7%比 23.2%）。费利蒙娜组最常见的诊断是桡骨远端骨折（16.2%），是对照组的五倍（3.4%）。踝关节（21.7%）和肱骨近端（33%）骨折的发病率也显著增加。在费利蒙娜组，手术治疗的骨折增加了 168%，且更为严重，因为 C 型骨折更为常见（23%比 13%）。暴风雪期间手术平均延迟 6.78 天。
意外的暴风雪会导致矫形外科护理需求和 OED 压力呈指数级增长。预计骨科创伤手术会增加 168%，尤其是桡骨远端、肱骨近端和踝关节骨折，这将意味着择期手术取消，损害患者并增加成本。
