Skip to main content
JDRS · Open access journal

Original Article | Preliminary Reports After the 2023 Türkiye Earthquakes · Open access

Evaluation of musculoskeletal injuries after the 2023 Kahramanmaras earthquake: A local hospital experience

PDF Cite this article

Burak Kulakoğlu

Department of Orthopedics and Traumatology, Kilis Prof. Dr. Alaeddin Yavaşca State Hospital, Kilis, Türkiye

ORCID: 0000-0002-5590-8484

Zafer Uzunay

Department of Orthopedics and Traumatology, Kilis Prof. Dr. Alaeddin Yavaşca State Hospital, Kilis, Türkiye

ORCID: 0009-0005-5340-6826

Kaan Pota

Department of Orthopedics and Traumatology, Kilis Prof. Dr. Alaeddin Yavaşca State Hospital, Kilis, Türkiye

ORCID: 0000-0002-9250-9140

Nurettin Varhan

Department of Orthopedics and Traumatology, Kilis Prof. Dr. Alaeddin Yavaşca State Hospital, Kilis, Türkiye

ORCID: 0009-0009-1424-3699

Mahmut Gazi Fırat

Department of Orthopedics and Traumatology, Kilis Prof. Dr. Alaeddin Yavaşca State Hospital, Kilis, Türkiye

ORCID: 0000-0003-4335-5584

Abstract

Objectives: The aim of this study was to evaluate musculoskeletal injuries, clinical follow-ups and treatments of trauma patients admitted to our hospital after the 2023 Kahramanmaras earthquake.

Patients and methods: Between February 6th, 2023 and February 16th, 2023, a total of 957 trauma patients (452 males, 505 females; mean age: 36.2±19.9 years; range, 0 to 97 years) who were affected by the earthquake were retrospectively analyzed. Age, sex, presence of orthopedic consultation, diagnosis of open/closed fracture, diagnosis of dislocation, presence and classification of soft tissue injury, additional system injury, preoperative and postoperative neurovascular examination status, presence of compartment syndrome, conservative/surgical applications, operation side, fasciotomy surgery and level, amputation surgery and level, length of stay in the hospital and intensive care unit (ICU), the Mangled Extremity Severity Score (MESS) score were collected.

Results: A total of 811 of the survivors were Turkish and 146 were Syrians. Of 957 earthquake victims, 40% had soft tissue injuries, 19% had closed fractures, 8.9% had other system injuries, 7.7% had crush injuries, 4.1% had nerve injuries, 2.1% had compartment syndrome, 2.1% had vascular injury, 1.8% had dislocation, and 1.7% had open fracture. Surgical or conservative treatments were applied to 574 patients with musculoskeletal injuries. Conservative treatment was applied to 322 of 574 patients and surgical procedure was applied to 252 patients.

Conclusion: The highest patient density is experienced within the first 24 h after a devastating earthquake. The most common injuries due to high-energy trauma are isolated soft tissue injuries and fractures. The definition of the demographic characteristics and clinical outcomes of earthquake patients is critical to the development of preparedness, response, and recovery policies for future disasters..

Declarations

Ethics Committee Approval

The study protocol was approved by the Ankara City Hospital Clinical Research Ethics Committee (date: 08.03.2023, no: E1-23-3368). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Idea/concept, analysis and/or interpretation, critical review, materials: B.K., Z.U.; Design, literature review: K.P., N.V.; Control/supervision: M.G.F.; Data collection and/or processing, writing the article, references and fundings: B.K, Z.U.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Patient Consent for Publication

A written informed consent was obtained from the parents and/or legal guardians of the patients.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. World Health Organization. WHO flash appeal Earthquake response in Türkiye and Whole of Syria. Geneva: World Health Organization, 10 February 2023. Available at: https://cdn.who.int/media/docs/defaultsource/documents/emergencies/2023/who_flashappeal_ earthquakeresponse_11-feb-2023.pdf?sfvrsn=94d4de2a_1.
  2. Bartels SA, VanRooyen MJ. Medical complications associated with earthquakes. Lancet 2012;379:748-57. DOI: 10.1016/S0140-6736(11)60887-8.
  3. Giri S, Risnes K, Uleberg O, Rogne T, Shrestha SK, Nygaard ØP, et al. Impact of 2015 earthquakes on a local hospital in Nepal: A prospective hospital-based study. PLoS One 2018;13:e0192076. DOI: 10.1371/journal.pone.0192076.
  4. Schultz CH, Koenig KL, Noji EK. A medical disaster response to reduce immediate mortality after an earthquake. N Engl J Med 1996;334:438-44. DOI: 10.1056/NEJM199602153340706.
  5. Peek-Asa C, Kraus JF, Bourque LB, Vimalachandra D, Yu J, Abrams J. Fatal and hospitalized injuries resulting from the 1994 Northridge earthquake. Int J Epidemiol 1998;27:459-65. DOI: 10.1093/ije/27.3.459.
  6. Armenian HK, Melkonian A, Noji EK, Hovanesian AP. Deaths and injuries due to the earthquake in Armenia: A cohort approach. Int J Epidemiol 1997;26:806-13. DOI: 10.1093/ije/26.4.806.
  7. Shoaf KI, Sareen HR, Nguyen LH, Bourque LB. Injuries as a result of California earthquakes in the past decade. Disasters 1998;22:218-35. DOI: 10.1111/1467-7717.00088.
  8. Bortolin M, Morelli I, Voskanyan A, Joyce NR, Ciottone GR. Earthquake-related orthopedic injuries in adult population: A systematic review. Prehosp Disaster Med 2017;32:201-8. DOI: 10.1017/S1049023X16001515.
  9. Görmeli G, Görmeli CA, Güner S, Ceylan MF, Dursun R. The clinical profile of musculoskeletal injuries associated with the 2011 Van earthquake in Turkey. Eklem Hastalik Cerrahisi 2012;23:68-71.
  10. Mohebbi HA, Mehrvarz S, Saghafinia M, Rezaei Y, Kashani SM, Naeeni SM, et al. Earthquake related injuries: Assessment of 854 victims of the 2003 Bam disaster transported to tertiary referral hospitals. Prehosp Disaster Med 2008;23:510-5. DOI: 10.1017/s1049023x00006336.
  11. Hussain E, Kalaycıoğlu S, Milliner CWD, Çakir Z. Preconditioning the 2023 Kahramanmaraş (Türkiye) earthquake disaster. Nat Rev Earth Environ 2023;4:287-9. DOI: 10.1038/s43017-023-00411-2b.
  12. Atik OŞ. Which articles do the editors prefer to publish? Jt Dis Relat Surg 2022;33:1-2. DOI: 10.52312/jdrs.2022.57903.
  13. McNamara MG, Heckman JD, Corley FG. Severe open fractures of the lower extremity: a retrospective evaluation of the Mangled Extremity Severity Score (MESS). J Orthop Trauma 1994;8:81-7. DOI: 10.1097/00005131-199404000-00001.
  14. Stein H, Hoerer D, Weisz I, Langer R, Revach M, Stahl S, et al. Musculoskeletal injuries in earthquake victims: An update on orthopedic management. Orthopedics 2000;23:1085-7. DOI: 10.3928/0147-7447-20001001-21.
  15. Huang W, Du L, Zhou L, Zhang X, Lui RC, Liu Y, et al. Surgical outcomes after the Wenchuan earthquake: Review of a single center’s experience. J Trauma 2010;69:731. DOI: 10.1097/TA.0b013e3181e983c6.
  16. Mulvey JM, Awan SU, Qadri AA, Maqsood MA. Profile of injuries arising from the 2005 Kashmir earthquake: The first 72 h. Injury 2008;39:554-60. DOI: 10.1016/j.injury.2007.07.025.
  17. Révész ES, Altorjay Á, Montskó V, Hangody L. Effectiveness of negative pressure wound therapy: Minimum five-year follow-up and review of the literature. Jt Dis Relat Surg 2022;33:51-6. DOI: 10.52312/jdrs.2022.547.
  18. Xu S, Shi B, Yuxian J, He M, Yang P, Xu W, et al. Comparative analysis of the wounded in patients and deaths in a hospital following the three major earthquakes in Western China. Front Public Health 2022;10:775130. DOI: 10.3389/fpubh.2022.775130.
  19. Winter M, Osmers I, Krieger S. Trauma surgery catastrophe aid following the earthquake in Haiti 2010--a report on experiences: Injury patterns, special challenges, prospects. Unfallchirurg 2011;114:79-84. DOI: 10.1007/s00113-010-1883-8.
  20. Matsuzawa G, Sano H, Ohnuma H, Tomiya A, Kuwahara Y, Hashimoto C, et al. Patient trends in orthopedic traumas and related disorders after tsunami caused by the Great East Japan Earthquake: An experience in the primary referral medical center. J Orthop Sci 2016;21:507-11. DOI: 10.1016/j.jos.2016.03.007.
  21. Phalkey R, Reinhardt JD, Marx M. Injury epidemiology after the 2001 Gujarat earthquake in India: A retrospective analysis of injuries treated at a rural hospital in the Kutch district immediately after the disaster. Glob Health Action 2011;4:7196. DOI: 10.3402/gha.v4i0.7196.
  22. Lebel E, Blumberg N, Gill A, Merin O, Gelfond R, Bar-On E. External fixator frames as interim damage control for limb injuries: Experience in the 2010 Haiti earthquake. J Trauma 2011;71:E128-31. DOI: 10.1097/TA.0b013e3182147654.
  23. Awais S, Saeed A, Ch A. Use of external fixators for damage-control orthopaedics in natural disasters like the 2005 Pakistan earthquake. Int Orthop 2014;38:1563-8. DOI: 10.1007/s00264-014-2436-5.
  24. Lichte P, Kobbe P, Dombroski D, Pape HC. Damage control orthopedics: Current evidence. Curr Opin Crit Care 2012;18:647-50. DOI: 10.1097/MCC.0b013e328359fd57.
  25. Rush RM Jr, Arrington ED, Hsu JR. Management of complex extremity injuries: Tourniquets, compartment syndrome detection, fasciotomy, and amputation care. Surg Clin North Am 2012;92:987-1007, ix. DOI: 10.1016/j.suc.2012.06.003.
  26. Schmidt AH. Acute compartment syndrome. In: Bhandari M, editor. Evidence-based orthopedics. New Jersey: Blackwell Publishing; 2011. p. 627-35.
  27. Sheridan GW, Matsen FA 3rd. Fasciotomy in the treatment of the acute compartment syndrome. J Bone Joint Surg [Am] 1976;58:112-5.
  28. Zhang J, Ding W, Chen A, Jiang H. The prominent role of plastic surgery in the Wenchuan earthquake disaster. J Trauma 2010;69:964-9. DOI: 10.1097/TA.0b013e3181e9f0e0.