Orthopaedic burden in disaster: a scoping review.

Area of Science:

• Orthopaedic Surgery
• Disaster Medicine
• Public Health

Background:

• Global disasters, exacerbated by climate change and geopolitical instability, increasingly challenge healthcare systems.
• Musculoskeletal trauma is a significant cause of mortality and long-term disability in disaster settings.
• Understanding the scope of orthopaedic injuries is vital for effective disaster response and rehabilitation.

Purpose of the Study:

• To conduct a scoping review of the orthopaedic burden in disaster settings.
• To analyze demographic data, injury patterns, and interventions for orthopaedic trauma in disasters.
• To identify gaps in research and reporting standards for disaster-related orthopaedic injuries.

Main Methods:

• A comprehensive scoping review was performed adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Searches were conducted in the PUBMED and EMBASE databases for original studies published between 2003 and 2023.
• Data extraction focused on patient demographics, injury distribution, and orthopaedic interventions, followed by qualitative analysis.

Main Results:

• Ten studies, covering 24,621 patients, met the inclusion criteria, with earthquakes being the most frequent disaster type.
• Extremity injuries constituted 52-93% of all injuries, predominantly affecting the lower limbs.
• Surgical intervention rates varied widely (0.2%-82.3%), with wound debridement being most common; compartment syndrome affected 2%-29.9% of cases. Study quality was generally poor.

Conclusions:

• Orthopaedic injuries represent the largest proportion of trauma in disaster scenarios, necessitating specialized surgical expertise.
• The development and implementation of standardized reporting are essential for comparing injury profiles across different disasters.
• Future research must prioritize comprehensive reporting standards and investigate long-term outcomes in disaster response settings.