Orthopedic Injuries and Their Treatment in Children During Earthquakes: A Systematic Review. Issue 5 (19th August 2015)

• Record Type: Journal Article
• Authors: Morelli, Ilaria; Sabbadini, Maria Grazia; Bortolin, Michelangelo
• Is Part Of: Prehospital and disaster medicine. Volume 30:Issue 5(2015)
• Page Start: 478
• Page End: 485
• Publication Date: 2015-08-19
• Subjects: amputation, -- earthquake, -- external fixation, -- orthopedics, -- pediatric trauma, -- systematic review; Emergency medical services -- Periodicals; Emergency medicine -- Periodicals; Disaster medicine -- Periodicals; 616.025
• DOI: 10.1017/S1049023X15004951
• Languages: English
• ISSNs: 1049-023X

Abstract

Abstract: Orthopedic injuries commonly affect children during earthquakes, but reports about them are rare. This setting may lead to different standards of care, but guidelines are still missing in this field. A systematic review was performed to: (1) assess type and body distribution of pediatric earthquake-related injuries, treatment performed, length of stay, and complications; and (2) identify starting points to define standards of care. PubMed database was researched for papers (1999-2014 period) in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Inclusion criteria were: English, French, Spanish, or Italian language and data reported about orthopedic lesions in children (≤18 years old). Reviews, letters, commentaries, editorials, and single case reports were excluded. Two independent reviewers selected articles after abstract and full-text reading. Traumatic injuries caused child hospital admissions ranging from 46.9% to 100.0%; 16% to 53% suffered fractures. Lower limbs mostly were involved. Soft-tissue injuries affected 55% of patients. Debridement and external fixation (EF) were the most frequent surgical treatments. Amputation rates varied from 5% to 11%. This study revealed that field hospitals should be prepared to: (1) treat mainly lower extremities fractures in children; and (2) use especially EF techniques. The presence of orthopedic surgeons familiar with pediatric traumatology should be considered. I Morelli, MG Sabbadini, M Bortolin .Orthopedic injuries and their treatment in children during earthquakes: a systematic review .Prehosp Disaster Med .2015 ;30(5 ):478 –485 .