title: The extent of soft tissue and musculoskeletal injuries after earthquakes; describing a role for reconstructive surgeons in an emergency response.
abstract: BACKGROUND
  Earthquakes are the leading cause of natural disaster-related mortality and morbidity. Soft tissue and musculoskeletal injuries are the predominant type of injury seen after these events and a major reason for admission to hospital. Open fractures are relatively common; however, they are resource-intense to manage. Appropriate management is important in minimising amputation rates and preserving function. This review describes the pattern of musculoskeletal and soft-tissue injuries seen after earthquakes and explores the manpower and resource implications involved in their management.
  
  
  METHODS
  A Medline search was performed, including terms "injury pattern" and "earthquake," "epidemiology injuries" and "earthquakes," "plastic surgery," "reconstructive surgery," "limb salvage" and "earthquake." Papers published between December 1992 and December 2012 were included, with no initial language restriction.
  
  
  RESULTS
  Limb injuries are the commonest injuries seen accounting for 60 % of all injuries, with fractures in more than 50 % of those admitted to hospital, with between 8 and 13 % of these fractures open. After the first few days and once the immediate lifesaving phase is over, the management of these musculoskeletal and soft-tissue injuries are the commonest procedures required.
  
  
  CONCLUSIONS
  Due to the predominance of soft-tissue and musculoskeletal injuries, plastic surgeons as specialists in soft-tissue reconstruction should be mobilised in the early stages of a disaster response as part of a multidisciplinary team with a focus on limb salvage.
authors.affiliation: Department of Plastic Surgery, Cork University Hospital, Wilton, Cork, Ireland, j.clover@ucc.ie.
authors.forename: A J P
authors.initials: AJ
authors.lastname: Clover
authors.forename: B
authors.initials: B
authors.lastname: Jemec
authors.forename: A D
authors.initials: AD
authors.lastname: Redmond
mesh_terms: D000671:Amputation, Surgical / Q000706:statistics & numerical data; D004190:Disasters; D055866:Earthquakes; D050723:Fractures, Bone / Q000601:surgery*; D005597:Fractures, Open / Q000601:surgery; D006801:Humans; D023821:Limb Salvage; D009141:Musculoskeletal System / Q000293:injuries*; D010819:Physician's Role; D019651:Plastic Surgery Procedures; D017695:Soft Tissue Injuries / Q000601:surgery*; D013518:Surgery, Plastic