Orthopaedic burden in disaster: a scoping review.

Abstract

Introduction: Disasters are an increasing challenge to global healthcare systems due to climate change and geopolitical tensions. Traumatic injuries are prevalent in these crises, causing significant mortality and functional impairment. Understanding the burden of musculoskeletal trauma is crucial for enhancing disaster relief and rehabilitation efforts. This scoping review examines the orthopaedic burden in disaster.

Method: A scoping review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using PUBMED and EMBASE databases. Original studies published from 2003 to 2023 addressing orthopaedic trauma in disasters were included. Data on demographics, the anatomical distribution of injuries and orthopaedic intervention were extracted and analysed.

Results: The search identified 602 studies, with 10 satisfying the inclusion criteria, encompassing 24 621 patients. Earthquakes were the most common disaster type. Extremity injuries accounted for 52-93% of total injuries, with lower limb trauma predominating. In the majority of studies, the most common surgical intervention was wound debridement. The proportion of patients undergoing surgical intervention varied widely from 0.2% to 82.3%. Compartment syndrome when recorded ranged from 2% to 29.9% of cases. The quality of the studies was generally poor, with inconsistent reporting standards and limited outcome data.

Discussion: Orthopaedic injuries form the largest component of trauma in disaster settings, emphasising the need for surgical expertise. Standardised reporting is vital for improving the understanding and comparison of injury profile associated with different catastrophes. Future research should focus on comprehensive reporting standards and long-term outcomes associated with disaster response.

Conclusion: This review underscores the critical role of orthopaedics in disaster response and the need for universal reporting standards to optimise care in austere environments.