Abstract
Objectives: This study aims to investigate the pattern of Musculoskeletal and soft tissue injuries in a series of referred patients in a tertiary medical center and review previous reports in the literature.
Methods: In this study, we recorded musculoskeletal injuries of the victims, following the Kermanshah earthquake on November 12, 2017, with a total number of 38. All patients were admitted to the Imam Khomeini Hospital. Injury type, site of injury, gender, age, complications, mortality, and treatment modality were recorded for each case.
Results: Among 38 patients, 18 were male (47%) and 20 were female (53%). The mean age was 37 ± 21.6 years. Most of them were aged between 18 and 65 (71.1%). Lower extremities were involved more than the upper (37% versus 24%) and distal limb involvement was more than the proximal (57.3% versus 43.7%). One patient died due to necrotizing fasciitis and septic shock after femoral shaft open fracture. Two patients developed compartment syndrome and underwent fasciotomy complications by skin necrosis and infection.
Conclusions: Soft tissue injuries and fractures are the most common injuries following the earthquakes, hence orthopedic surgeries play a vital role in disasters. Despite patients overload and emergency situation in natural disasters like earthquakes, it is crucial to have a stepwise and evidence based approach for each patient. For the patients with open fractures referred to a tertiary center, careful contamination assessment even in the previously managed wounds is highly recommended, especially for those with early wound closure. Early fasciotomy in the crush syndrome is not beneficial as it has adverse effects such as skin necrosis and infection.