title: A review of the epidemiology and treatment of orthopaedic injuries after earthquakes in developing countries.
abstract: Earthquakes in developing countries are devastating events. Orthopaedic surgeons play a key role in treating earthquake-related injuries to the extremities. We describe orthopaedic injury epidemiology to help guide response planning for earthquake-related disasters.
  
  
  
  Several databases were searched for articles reporting primary injury after major earthquakes from 1970 to June 2016. We used the following key words: "earthquake" AND "fracture" AND "injury" AND "orthopedic" AND "treatment" AND "epidemiology." The initial search returned 528 articles with 253 excluded duplicates. The remaining 275 articles were screened using inclusion criteria, of which the main one was the description of precise anatomic location of fracture. This yielded 17 articles from which we analyzed the ratio of orthopaedic to nonorthopaedic injuries; orthopaedic injury location, type, and frequency; fracture injury characteristics (open vs. closed, single vs. multiple, and simple vs. comminuted); and first-line treatments.
  
  
  
  Most injuries requiring treatment after earthquakes (87%) were orthopaedic in nature. Nearly two-thirds of these injuries (65%) were fractures. The most common fracture locations were the tibia/fibula (27%), femur (17%), and foot/ankle (16%). Forty-two percent were multiple fractures, 22% were open, and 16% were comminuted. The most common treatment for orthopaedic injuries in the setting of earthquakes was debridement (33%).
  
  
  
  Orthopaedic surgeons play a critical role after earthquake disasters in the developing world. A strong understanding of orthopaedic injury epidemiology and treatment is critical to providing effective preparation and assistance in future earthquake disasters.
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, 21287 MD USA.
authors.forename: James S
authors.initials: JS
authors.lastname: MacKenzie
authors.affiliation: Department of Orthopaedics, Hospital and Rehabilitation Centre for Disabled Children, Adhikari Gaoun, Urgratara VDC-6, Janagal Kavre Nepal.
authors.forename: Bibek
authors.initials: B
authors.lastname: Banskota
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, 21287 MD USA.|Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Rd., Ratchatewi, Bangkok, 10400 Thailand.
authors.forename: Norachart
authors.initials: N
authors.lastname: Sirisreetreerux
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, 21287 MD USA.
authors.forename: Babar
authors.initials: B
authors.lastname: Shafiq
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, 21287 MD USA.|Department of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., #A667, Baltimore, 21224-2780 MD USA.
authors.forename: Erik A
authors.initials: EA
authors.lastname: Hasenboehler
mesh_terms: D003906:Developing Countries / Q000706:statistics & numerical data*; D055866:Earthquakes / Q000706:statistics & numerical data*; D004813:Epidemiology; D006801:Humans; D019637:Orthopedic Procedures / Q000379:methods / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology / Q000601:surgery*
keywords: Developing countries; Earthquake; Epidemiology; Orthopaedic injury