in the name of god. snow snow catastrophe condition: how much does it affect the orthopedic...
TRANSCRIPT
In the name of God
SnowSnow catastrophe condition: How much does it affect the
orthopedic injuries?
Mohsen Mardani-Kivi, M.D. Orthopedic
Department, Guilan University Of Medical
Sciences
SnowSnow catastrophe condition: How much does it affect the
orthopedic injuries?
Mohsen Mardani-Kivi, M.D. Orthopedic
Department, Guilan University Of Medical
Sciences
Background
• Iran is one of the most high risk natural disaster countries (6th place among all countries).
Background
• Natural disasters victimize 150,000 cases annually (3 million individuals in 20 years)
• Guilan 3 episodes of snow crisis in the last decade
Background
• Subtle knowledge +learning from the previous experiences more cost effective approaches for future catastrophes
Background
• During the snow crisis, the patternpattern and mechanismmechanism of injuries alter due to changing in traffic and increasing the slipping and falling risks.
The purpose of the study
• Since there is no such study about the incidence of snow related trauma in our country, the present study seeks to analyze the snow injuries in year 2014 for precaution and prevention of trauma in possible future catastrophes.
Methods and Materials:
Results
Results
Results
Results
Results
IcyIcy daysdays significantly resulted in moremore injuries than snowy days (P< 0.001).
Results
• The mean of fracture rate per day was 54.7 cases which were 4.5 4.5 times times more than a similar time in 2 years ago (11.6 fracture per day).
Results:• The incidence of all fractures in menmen
were significantly more than women (P<0.0001).
• Among those patients > 65 yrs Frequency of the lower limb lower limb fractures were more than upper ones years.
Results:
α. The number in parentheses are demonstrated the percentage of the injury in every anatomical site.β. MVA: motor-vehicle accident
Mechanism of injury
Slipping (%)α Falling (%) MVAβ (%) Others (%) Overall
Upper limb 171 (76%) 15(7%) 14(6%) 26(11%) 226
Lower limb 62(71%) 10(12%) 9(10%) 6(7%) 87
Orthopedic 256(82%) 25(8%) 0(82%) 32(10%) 313
Head & neck 26(47%) 23(42%) 6(11%) 0(0%) 55
Trunk 3(23%) 10(77%) 0(0%) 0(0%) 13
Table1. Mechanism of injuries in anatomical sites
Results:
Discussion• Snow crisis and the increasing rate of
slipping in European studies:– Ralis et al.: reported an increase of
in fracture rate at four-day period after snow in Cardiff.• Elderly (especially women) • The upper limb fx (59% of cases)• the most common fx distal radius fx
2.6 times2.6 times
Discussion
• Ralis et al. – Results of 6 similar studies; – they concluded that there is an increase
(4.5 times4.5 times more than usual) in fractures rate
Discussion
• In Norway:– the frequency of fx unrelated to MVA in
snowy winter days were documented. – 39% of fx were due to slipping on the
ice or snow – 45% of those cases were suffered from
upper extremities fx
Why?!
• Ice formation: 1. The surface of ice is crinkled due to subsiding
snowflake.2. The following decrease in temperature at
night protects the snow from defrosting. 3. With increase in temperature in the next day,
the ice surface would thaw and again it would become frozen in the night.
This mechanism would form a smooth and plain layer of ice that increases the rate of slipping and falling.
Why?!
• On the other hand, in the first day of snow crises, a large percentage of people may stay at home, however as the time passes, people start to come out to the icy streets
• Lewis et al. – the peak days of trauma may happen at
the 6th day after snow.
Summary• Icy days: 3-6 days after snow• The most common mechanism:
SlippingSlipping• IcyIcy days > snowy days• menmen > women• UpperUpper > lower • Distal Raius Fx & Hip Fx
Take home message
Be careful for the IcyIcy days instead of Snowy days!
Any suggestions?