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Médecins Sans Frontières Experience in Orthopedic Surgery in Postearthquake Haiti in 2010

Published online by Cambridge University Press:  15 January 2014

Carrie Lee Teicher Open the ORCID record for Carrie Lee Teicher [Opens in a new window] ,
Kathryn Alberti ,
Klaudia Porten ,
Greg Elder ,
Emannuel Baron  and
Patrick Herard
Carrie Lee Teicher*
Affiliation:
Médecins Sans Frontières/Doctors Without Borders, Epicentre/Medical Department, New York, New York USA
Kathryn Alberti
Affiliation:
Médecins Sans Frontières/Doctors Without Borders, Epicentre/Medical Department, New York, New York USA
Klaudia Porten
Affiliation:
Médecins Sans Frontières/Doctors Without Borders, Epicentre/Medical Department, New York, New York USA
Greg Elder
Affiliation:
Médecins Sans Frontières/Doctors Without Borders, Epicentre/Medical Department, New York, New York USA
Emannuel Baron
Affiliation:
Médecins Sans Frontières/Doctors Without Borders, Epicentre/Medical Department, New York, New York USA
Patrick Herard
Affiliation:
Médecins Sans Frontières/Doctors Without Borders, Epicentre/Medical Department, New York, New York USA
*
Correspondence: Carrie Lee Teicher, MD Médecins Sans Frontières/Doctors Without Borders Epicentre/Medical Department 333 Seventh Ave Second Floor New York, NY 10001 USA E-mail carrie.teicher@newyork.msf.org
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Abstract

Introduction

During January 2010, a 7.0 magnitude earthquake struck Haiti, resulting in death and destruction for hundreds of thousands of people. This study describes the types of orthopedic procedures performed, the options for patient follow-up, and limitations in obtaining outcomes data in an emergency setting.

Problem

There is not a large body of data that describes larger orthopedic cohorts, especially those focusing on internal fixation surgeries in resource-poor settings in postdisaster regions. This article describes 248 injuries and over 300 procedures carried out in the Médecins Sans Frontières-Orthopedic Centre Paris orthopedic program.

Methods

Surgeries described in this report were limited to orthopedic procedures carried out under general anesthesia for all surgical patients. Exclusion factors included simple fracture reduction, debridement, dressing changes, and removal of hardware. This data was collected using both prospective and retrospective methods; prospective inpatient data were collected using a data collection form designed promptly after the earthquake and retrospective data collection was performed in October 2010.

Results

Of the 264 fractures, 204 were fractures of the major long bones (humerus, radius, femur, tibia). Of these 204 fractures of the major long bones, 34 (16.7%) were upper limb fractures and 170 (83.3%) were lower limb fractures. This cohort demonstrated a large number of open fractures of the lower limb and closed fractures of the upper limb. Fractures were treated according to their location and type. Of the 194 long bone fractures, the most common intervention was external fixation (36.5%) followed by traction (16.7%), nailing (15.1%), amputation (14.6%), and plating (9.9%).

Conclusion

The number of fractures described in this report represents one of the larger orthopedic cohorts of patients treated in a single center in the aftermath of the 2010 earthquake in Haiti. The emergent surgical care described was carried out in difficult conditions, both in the hospital and the greater community. While outcome and complication data were limited, the proportion of patients attending follow-up most likely exceeded expectations and may reflect the importance of the rehabilitation center. This data demonstrates the ability of surgical teams to perform highly-specialized surgeries in a disaster zone, and also reiterates the need for access to essential and emergency surgical programs, which are an essential part of public health in low- and medium-resource settings.

TeicherCL , AlbertiK , PortenK , ElderG , BaronE , HerardP . Médecins Sans Frontières Experience in Orthopedic Surgery in Postearthquake Haiti in 2010. Prehosp Disaster Med. 2014;29(1):1-6.

Keywords

disastersearthquakesHaitiinternational agenciesorthopedics
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 1 , February 2014 , pp. 21 - 26
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

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