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Anshori F, Kamal AF, Prabowo Y, Kekalih A, Febrianto R, Purnaning D, Dilogo IH. The Outcome of Orthopedics Treatment of Lombok Earthquake Victim 2018: A Cohort of One-Year Follow-Up Study-Lesson Learned After Lombok Earthquake. Orthop Res Rev 2023; 15:91-103. [PMID: 37193319 PMCID: PMC10182807 DOI: 10.2147/orr.s387625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/25/2023] [Indexed: 05/18/2023] Open
Abstract
Introduction There was a magnitude 7 on the Richter scale earthquake on Lombok Island in 2018, causing more than 500 deaths. In the event of earthquakes, there is often an imbalance between overcrowding in hospitals and inadequate resources. The initial management of earthquake victims with musculoskeletal injuries is controversial, arguing over whether to utilize debridement, external or internal fixation, or conservative or operative treatment in an acute onset disaster situation. This study aims to determine the outcome of initial management after the 2018 Lombok earthquake, between immediate open-reduction and internal fixation (ORIF) and Non-ORIF procedures after one year follow-up. Methods This is a cohort study to evaluate radiological and clinical outcomes one year after orthopedic treatment in the Lombok earthquake 2018. The subjects were recruited from eight public health center and one hospital in Lombok in September 2019. We evaluate radiological outcomes (non/malunion and union) and clinical outcomes (infection and SF-36 score). Results Based on 73 subjects, the ORIF group has a higher union rate than the non-ORIF group (31.1% vs. 68.9%; p = 0.021). Incidence of infection only appeared in the ORIF group (23.5%). Clinical outcome as measured by SF36 showed the ORIF group had a lower mean of general health (p = 0.042) and health change (p = 0.039) clinical outcomes than the non-ORIF group. Discussion The most affected public group is the productive age with significant impact on social-economy. ORIF procedure is a major risk factor of infection in initial treatment after earthquake. Therefore, definitive operation with internal fixation is not recommended in the initial phase of a disaster. Damage Control Orthopedic (DCO) surgery protocol is the treatment of choice in acute disaster setting. Conclusion The ORIF group had better radiological outcomes than the non-ORIF group. However the ORIF group had higher cases of infection and lower SF-36 than the non-ORIF group. Definitive treatment in acute onset disaster setting should be prevented.
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Affiliation(s)
- Fahmi Anshori
- Departement of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Achmad Fauzi Kamal
- Departement of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Yogi Prabowo
- Departement of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Aria Kekalih
- Community Medicine Department, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rudi Febrianto
- Orthopaedic and Traumatology Division, Department of Surgery, Faculty of Medicine University of Mataram -Regional General Hospital of West Nusa Tenggara, Mataram, Indonesia
| | - Dyah Purnaning
- Orthopaedic and Traumatology Division, Department of Surgery, Faculty of Medicine University of Mataram -Regional General Hospital of West Nusa Tenggara, Mataram, Indonesia
| | - Ismail Hadisoebroto Dilogo
- Departement of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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The Ethical Triage and Management Guidelines of the Entrapped and Mangled Extremity in Resource Scarce Environments: A Systematic Literature Review. Disaster Med Public Health Prep 2020; 15:389-397. [PMID: 32456743 DOI: 10.1017/dmp.2020.49] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE A systematic literature review (SLR) was performed to elucidate the current triage and treatment of an entrapped or mangled extremity in resource scarce environments (RSEs). METHODS A lead researcher followed the search strategy following inclusion and exclusion criteria. A first reviewer (FR) was randomly assigned sources. One of the 2 lead researchers was the second reviewer (SR). Each determined the level of evidence (LOE) and quality of evidence (QE) from each source. Any differing opinions between the FR and SR were discussed between them, and if differing opinions remained, then a third reviewer (the other lead researcher) discussed the article until a consensus was reached. The final opinion of each article was entered for analysis. RESULTS Fifty-eight (58) articles were entered into the final study. There was 1 study determined to be LOE 1, 29 LOE 2, and 28 LOE 3, with 15 determined to achieve QE 1, 37 QE 2, and 6 QE 3. CONCLUSION This SLR showed that there is a lack of studies producing strong evidence to support the triage and treatment of the mangled extremity in RSE. Therefore, a Delphi process is suggested to adapt and modify current civilian and military triage and treatment guidelines to the RSE.
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Wen PS, Randolph MG, Elbaum L, De la Rosa M. Gender Differences in Psychosocial and Physical Outcomes in Haitian Amputees. Am J Occup Ther 2018; 72:7203205090p1-7203205090p8. [PMID: 29689178 PMCID: PMC5915231 DOI: 10.5014/ajot.2018.022962] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the gender differences in psychosocial and physical outcomes in users of lower-extremity prostheses who became amputees after the 2010 earthquake in Haiti. METHOD We enrolled 140 unilateral amputees in this cross-sectional study in Port-au-Prince, Haiti. Trained staff administered the assessments by reading the questions aloud to participants. Participants completed the Trinity Amputation and Prosthesis Experience Scales and Locomotor Capabilities Index about 2 yr after the earthquake. RESULTS We found no gender differences in psychosocial adjustment and physical outcomes, except for strenuous physical activities and phantom pain, and both genders reported difficulty in social adjustment. After controlling for strenuous physical activities and phantom pain, we found that men showed worse psychosocial adjustment than women. CONCLUSION Services for psychosocial adjustment are critical for traumatic amputees and should be incorporated into rehabilitation programs after a disaster. Interventions should consider gender roles in the indigenous culture.
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Affiliation(s)
- Pey-Shan Wen
- Pey-Shan Wen, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta;
| | - Marilys G Randolph
- Marilys G. Randolph, PhD, PT, is Retired; she was Associate Professor, Department of Physical Therapy, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami
| | - Leonard Elbaum
- Leonard Elbaum, PhD, PT, is Retired; he was Associate Professor, Department of Physical Therapy, Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami
| | - Mario De la Rosa
- Mario De la Rosa, MSSA, PhD, is Professor, Department of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami
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Gohy B, Ali E, Van den Bergh R, Schillberg E, Nasim M, Naimi MM, Cheréstal S, Falipou P, Weerts E, Skelton P, Van Overloop C, Trelles M. Early physical and functional rehabilitation of trauma patients in the Médecins Sans Frontières trauma centre in Kunduz, Afghanistan: luxury or necessity? Int Health 2016; 8:381-389. [PMID: 27738078 PMCID: PMC5181549 DOI: 10.1093/inthealth/ihw039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 07/04/2016] [Accepted: 07/07/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND In Afghanistan, Médecins Sans Frontières provided specialised trauma care in Kunduz Trauma Centre (KTC), including physiotherapy. In this study, we describe the development of an adapted functional score for patient outcome monitoring, and document the rehabilitation care provided and patient outcomes in relation to this functional score. METHODS A descriptive cohort study was done, including all patients admitted in the KTC inpatient department (IPD) between January and June 2015. The adapted functional score was collected at four points in time: admission and discharge from both IPD and outpatient department (OPD). RESULTS Out of the 1528 admitted patients, 92.3% (n = 1410) received at least one physiotherapy session. A total of 1022 patients sustained either lower limb fracture, upper limb fracture, traumatic brain injury or multiple injury. Among them, 966 patients received physiotherapy in IPD, of whom 596 (61.7%) received IPD sessions within 2 days of admission; 696 patients received physiotherapy in OPD. Functional independence increased over time; among patients having a functional score taken at admission and discharge from IPD, 32.2% (172/535) were independent at discharge, and among patients having a functional score at OPD admission and discharge, 79% (75/95) were independent at discharge. CONCLUSIONS The provision of physiotherapy was feasible in this humanitarian setting, and the tailored functional score appeared to be relevant.
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Affiliation(s)
- Bérangère Gohy
- Handicap International, Operational Centre Lyon, Emergency Technical Unit, Lyon, France
| | - Engy Ali
- Médecins sans Frontières, Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), Luxembourg, Luxembourg
| | - Rafael Van den Bergh
- Médecins sans Frontières, Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), Luxembourg, Luxembourg
| | - Erin Schillberg
- Médecins sans Frontières, Operational Centre Brussels, Medical Department, Operational Research Unit (LuxOR), Luxembourg, Luxembourg
| | - Masood Nasim
- Médecins Sans Frontières-Operational Centre Brussels, Afghanistan mission, Kabul, Afghanistan
| | - Muhammad Mahmood Naimi
- Médecins Sans Frontières-Operational Centre Brussels, Afghanistan mission, Kunduz Trauma Centre, Afghanistan
| | - Sophia Cheréstal
- Médecins Sans Frontières-Operational Centre Brussels, Haiti mission, Port-au-Prince, Haiti
| | - Pauline Falipou
- Handicap International, Operational Centre Lyon, Emergency Technical Unit, Lyon, France
| | - Eric Weerts
- Handicap International, Operational Centre Lyon, Emergency Technical Unit, Lyon, France
| | - Peter Skelton
- Handicap International, Operational Centre Lyon, Emergency Technical Unit, Lyon, France
| | - Catherine Van Overloop
- Médecins Sans Frontières-Operational Centre Brussels, Operational Department, Brussels, Belgium
| | - Miguel Trelles
- Médecins sans Frontières, Operational Centre Brussels, Medical Department, Surgical Unit, Brussels, Belgium
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Hunt MR, Chung R, Durocher E, Henrys JH. Haitian and international responders' and decision-makers' perspectives regarding disability and the response to the 2010 Haiti earthquake. Glob Health Action 2015; 8:27969. [PMID: 26257047 PMCID: PMC4530138 DOI: 10.3402/gha.v8.27969] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/02/2015] [Accepted: 06/25/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Following disasters, persons with disabilities (PWD) are especially vulnerable to harm, yet they have commonly been excluded from disaster planning, and their needs have been poorly addressed during disaster relief. Following the 2010 Haiti earthquake, thousands of individuals experienced acute injuries. Many more individuals with preexisting disabilities experienced heightened vulnerability related to considerations including safety, access to services, and meeting basic needs. OBJECTIVE The objective of this research was to better understand the perceptions of responders and decision-makers regarding disability and efforts to address the needs of PWD following the 2010 earthquake. DESIGN We conducted a qualitative study using interpretive description methodology and semistructured interviews with 14 Haitian and 10 international participants who were involved in the earthquake response. RESULTS Participants identified PWD as being among the most vulnerable individuals following the earthquake. Though some forms of disability received considerable attention in aid efforts, the needs of other PWD did not. Several factors were identified as challenges for efforts to address the needs of PWD including lack of coordination and information sharing, the involvement of multiple aid sectors, perceptions that this should be the responsibility of specialized organizations, and the need to prioritize limited resources. Participants also reported shifts in local social views related to disability following the earthquake. CONCLUSIONS Addressing the needs of PWD following a disaster is a crucial population health challenge and raises questions related to equity and responsibility for non-governmental organizations, governments, and local communities.
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Affiliation(s)
- Matthew R Hunt
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation, Montreal, QC, Canada;
| | - Ryoa Chung
- Department of Philosophy, University of Montreal, Montreal, QC, Canada
| | - Evelyne Durocher
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Jean Hugues Henrys
- Faculty of Medicine and Health Sciences, Université Notre Dame d'Haiti, Port-au-Prince, Haiti
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