Orthopedic Injuries and Their Treatment in Children During Earthquakes: A Systematic Review.
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.
1Orthopaedics and Traumatology Department,Vita-Salute San Raffaele University - San Raffaele Hospital,Milan,Italy.
Ilaria
I
Morelli
2Internal Medicine - Clinical Immunology,Rheumatology and Allergy Section,Vita-Salute San Raffaele University - San Raffaele Hospital,Milan,Italy.
Maria Grazia
MG
Sabbadini
1Orthopaedics and Traumatology Department,Vita-Salute San Raffaele University - San Raffaele Hospital,Milan,Italy.
Michelangelo
M
Bortolin
D002648:Child; D002675:Child, Preschool; D055866:Earthquakes / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008952:Mobile Health Units; D009985:Orthopedics / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000628:therapy
EF external fixation; OR operating room; PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses; amputation; earthquake; external fixation; orthopedics; pediatric trauma; systematic review