Management of orthopaedic injuries in Libyan civil war: experiences of a distant hospital
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ORIGINAL PAPER
Management of orthopaedic injuries in Libyan civil war: experiences of a distant hospital Çağdaş Biçen 1
&
Mehmet Akdemir 2
&
Ahmet Ekin 1
Received: 15 May 2020 / Accepted: 24 July 2020 # SICOT aisbl 2020
Abstract Aim of the study In this study, we aimed to evaluate the musculoskeletal injury types, infections, and treatments of the patients injured in Libyan civil war. Methods A total of 291 patients (288 male, 3 female) treated in our clinic, between November 2011 and April 2020, were included in our retrospective study. Patients’ age, injury severity score (ISS), injury type, mechanism, location, accompanying traumas, infection, and operations in Libya and in our clinic were evaluated. Results Injuries were caused by gunshots in 172 patients, by explosives in 56, by missiles in eight, and by different mechanisms in the remaining 55 patients. Injuries were located mostly in lower extremities, followed by upper extremities and by both extremities. The most common fracture was tibial fractures, followed with femur and humerus. Plate-screw fixation was performed for 82 cases, intramedullary nailing for 42, external fixator for 41, K-wire fixation for 27, foreign body excisions for 26, arthrodesis for 15, amputation for , arthroplasty for 11, and soft tissue operations for 78. Infection was present among 50 (% 17.2) patients. Complications were seen in five patients. Three patients needed implant removal due to infection, one patient had a plate fracture, and one patient died because of sepsis. Discussion Difficulties in the treatment of war injuries begin in the battlefield. Patients’ transfers and treatments may not be provided properly due to unsuitable conditions. Hospitals in neighbouring and distant countries can be helpful for supporting the treatment of increased numbers of injured patients. Conclusion Wars cause excessive numbers of injuries. In this study, we want to show that hospitals far from war zones can be considered as alternatives for treatment of these injuries. Keywords Libya . Civil war . Polytrauma . Gunshot
Introduction Wars are affecting people around the world, and many thousands of people are killed or injured in these conflicts. Not
* Çağdaş Biçen [email protected] Mehmet Akdemir [email protected] Ahmet Ekin [email protected] 1
Department of Orthopedics and Traumatology, Medicalpark Izmir Hospital, İmbatlı Mah. Yeni Girne Bulv.1825. sok No:12, Izmir, Karşıyaka, Turkey
2
Department of Orthopedics and Traumatology, Konya Akademi Hospital, Izmir, Turkey
only military personnel are wounded, but large numbers of civilians are also injured [1]. Most of these injuries are caused by firearms, explosives, and shrapnel [2–4]. Due to the development of military hardware, mortality and injury rates have increased over the years [5]. Musculoskeletal injuries account for 65–70% of war injuries and most of them are open injuries [6–10]. Musculoskeletal injuries do not lead to high rates of mortality, but they are major causes of disability [11]. Polytraum
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