Systematic triage and treatment of earthquake victims: Our experience in a tertiary hospital after the 2023 Kahramanmaras earthquake.

OBJECTIVES: The aim of this study was to evaluate the benefits of our triage system in acceleration of intervention for the musculoskeletal injuries and clinical follow-ups of trauma patients admitted to our center after the Kahramanmaras earthquake. PATIENTS AND METHODS: Between February 6th, 2023 and February 20th, 2023, a total of 439 patients (207 males, 232 females; mean age: 37.1±19.1 years; range, 1 to 94 years) with earthquake-related musculoskeletal injuries after the Kahramanmaras earthquake were retrospectively analyzed. Data including age, sex, referral city information, removal time from the rubbles, physical examination findings, clinical photos, fasciotomy and amputation stumps and levels, and X-ray images and computed tomography images of all patients were shared and archived in the WhatsApp (Meta Platforms, Inc.® ATTN/CA, USA) group called 'Earthquake' created by orthopedic surgeons. To complete the patient interventions as soon as possible and to ensure order, the patients were distributed with the teams in order through this group by the consultant orthopedic surgeon. The treatments were applied and recorded according to the skin and soft tissue conditions, and fractures of the patients. All treatments were carried out with a multi-disciplinary approach. RESULTS: Of the patients, 16.2% were children. Lower limb injuries constituted 59.07% of musculoskeletal injuries. Upper limb, pelvic, and spinal cord injuries were observed in 21.9%, 12.7%, and 6.25%, respectively. Conservative treatment was applied to 183 (41.68%) patients. The most common surgical intervention was debridement (n=136, 53.1%). External fixation was applied in the first stage to 21 (8.2%) patients with open fractures. The mean removal time from the rubbles was 32.1±29.38 h. A total of 118 limb fasciotomy operations were applied to the patients. Fifty limb amputations were performed in 40 patients at the last follow-up due to vascular insufficiency and infection. CONCLUSION: Based on our study results, we believe that a triage system using a good communication and organization strategy is beneficial to prevent treatment delay and possible adverse events in future disasters.

Is pelvic mapping applicable in iliosacral screw fixation to determine screw entry point and screw trajectory?

OBJECTIVES: This study aims to investigate if pelvic mapping is applicable in iliosacral screw fixation to determine screw entry point and screw trajectory. PATIENTS AND METHODS: Clinical files and images of 16 patients (10 males, 6 females; mean age 35 years; range, 20 to 57 years) who underwent iliosacral screw fixation due to sacroiliac joint injury and sacrum fracture were retrospectively reviewed. Pelvic mapping was performed using preoperative tomography images of the patients and appropriate screw entry point and trajectory were determined. Postoperative computed tomography scans of all patients were obtained and these were used to evaluate the accuracy of the screw position. RESULTS: No intraoperative complications occurred. The entry points and trajectory of the screws were compatible for all patients pre- and postoperatively. CONCLUSION: Mapping of the pelvis is a method that can be used for preoperative planning of iliosacral screwing.