title: Patient trends in orthopedic traumas and related disorders after tsunami caused by the Great East Japan Earthquake: An experience in the primary referral medical center.
abstract: BACKGROUND
  In the Great East Japan Earthquake, the Japanese Red Cross Ishinomaki Hospital played an important role as a principal referral center within the Ishinomaki region, one of the most severely affected areas in eastern Japan. The present study describes the patient population, clinical characteristics, and time courses of the medical problems observed at this hospital.
  
  
  METHODS
  A retrospective survey of medical logs and records was conducted on the first 2 weeks after the earthquake to characterize orthopedic traumas and related disorders treated during this catastrophe. Patient number, severity of injuries, number of patients secondarily transported to the referral medical centers in the inland area, and the number of surgeries performed during the study period were investigated.
  
  
  RESULTS
  Totally, 7686 patients visited the hospital. Of which, 1807 patients suffered from exogenous diseases, such as trauma, burns, crush syndrome, deep venous thrombosis, and infectious diseases. Patients who suffered from hypothermia were the most frequently seen within the first 2 weeks after the earthquake. Interestingly, most patients' conditions were not severe and required only simple treatments. Four patients (0.2% of patients with exogenous diseases) were secondarily transported to the referral medical centers in the inland area and only four patients were surgically treated because of a lack of available implants, surgical devices, and electric power supply.
  
  
  CONCLUSIONS
  The Great East Japan Earthquake and subsequent tsunami, which occurred during an early spring afternoon, resulted in a unique orthopedic patient population, which included few severely injured patients compared with numerous deaths. We believe that each coastal region hospital should develop its own emergency medical care system to address future tsunami events while considering their surrounding environment. The information described in the present study should be important for preparation toward future events involving massive earthquakes followed by tsunami disasters.
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, Japan.
authors.forename: Gaku
authors.initials: G
authors.lastname: Matsuzawa
authors.affiliation: Division of Orthopedics, Sendai City Hospital, Japan. Electronic address: sanohirotaka@gmail.com.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sano
authors.affiliation: Department of Orthopaedic Surgery, Japanese Red Cross Ishinomaki Hospital, Japan.
authors.forename: Hideji
authors.initials: H
authors.lastname: Ohnuma
authors.affiliation: Department of Orthopaedic Surgery, Japanese Red Cross Ishinomaki Hospital, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Tomiya
authors.affiliation: Department of Orthopaedic Surgery, Japanese Red Cross Ishinomaki Hospital, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kuwahara
authors.affiliation: Department of Orthopaedic Surgery, Japanese Red Cross Ishinomaki Hospital, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Hashimoto
authors.affiliation: Department of Orthopaedic Surgery, Japanese Red Cross Ishinomaki Hospital, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Imamura
authors.affiliation: Medical Emergency Center, Japanese Red Cross Ishinomaki Hospital, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Ishibashi
authors.affiliation: Medical Emergency Center, Japanese Red Cross Ishinomaki Hospital, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Medical Emergency Center, Japanese Red Cross Ishinomaki Hospital, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Medical Emergency Center, Japanese Red Cross Ishinomaki Hospital, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ishii
authors.affiliation: Japanese Red Cross Ishinomaki Hospital, Japan.
authors.forename: Iwao
authors.initials: I
authors.lastname: Kaneda
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Itoi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D055866:Earthquakes; D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D054527:Mass Casualty Incidents; D008875:Middle Aged; D009141:Musculoskeletal System / Q000293:injuries*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D057192:Tsunamis; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult