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Extremity injuries in children resulting from the 1999 Marmara earthquake: an epidemiologic study
1Uludag University Medical School, Department of Orthopaedics and Traumatology, Burse, Turkey. bartu@uludag.edu.tr
Insights
Pediatric earthquake victims experienced similar injuries to adults, but faced higher risks of crush syndrome complications like acute renal failure and amputation. This highlights critical differences in orthopedic outcomes between age groups following major disasters.
Area of Science:
- Orthopedics
- Disaster Medicine
- Pediatric Traumatology
Background:
- Musculoskeletal injuries are common in mass casualty events.
- Understanding age-related differences in injury patterns is crucial for disaster response.
- The 1999 Marmara earthquake provides a case study for analyzing trauma in diverse populations.
Purpose of the Study:
- To compare the clinical features, types, and severity of musculoskeletal injuries in pediatric versus adult victims of the Marmara earthquake.
- To identify specific orthopedic challenges faced by children in the aftermath of a major seismic event.
Main Methods:
- Retrospective analysis of 151 hospitalized patients with musculoskeletal trauma from the Marmara earthquake.
- Categorization of patients into pediatric (under 16) and adult groups.
- Comparison of injury types, including extremity trauma and crush syndrome, and associated complications such as acute renal failure and amputation rates.
Main Results:
- Children (31/151, 20.5%) and adults sustained similar injury types, notably extremity trauma and crush syndrome.
- Pediatric patients with crush syndrome had a 18.5% rate of acute renal failure requiring hemodialysis and an 11.1% amputation rate.
- Adult patients with crush syndrome had significantly higher rates of acute renal failure (93.1%) and amputation (20.7%).
Conclusions:
- While injury types were similar, pediatric musculoskeletal trauma from the earthquake presented distinct orthopedic consequences compared to adults.
- Children experienced a lower incidence of severe crush syndrome complications requiring hemodialysis but a notable rate of amputation.
- These findings underscore the need for age-specific trauma management protocols in disaster scenarios.
Abstract:
The purpose of this study was to determine the clinical features, type and severity of musculoskeletal injuries in paediatric age groups in comparison with adult victims of the Marmara earthquake, which occurred on 17 August 1999. Of 151 injured patients hospitalized due to musculoskeletal trauma, 31 (20.5%) were under 16 years of age. The most important problems in the patients were extremity trauma, crush syndrome, acute renal failure and other ensuing medical complications. Five (18.5%) out of 27 children with crush syndrome required haemodialysis because of acute renal failure and three (11.1%) required amputation. Haemodialysis was needed in 54 (93.1%) of 58 adult patients with crush syndrome; amputation was necessary in 12 (20.7%) of them. Although the types of injuries resulting from the earthquake were similar in adults and children, the orthopaedic consequences of these injuries showed significant differences, especially in the rates of crush syndrome leading to acute renal failure and amputation.