Use of external fixators for damage-control orthopaedics in natural disasters like the 2005 Pakistan earthquake

Int Orthop. 2014 Aug;38(8):1563-8. doi: 10.1007/s00264-014-2436-5. Epub 2014 Jul 15.


Purpose: In the 2005 Pakistan earthquake, the great many injured with multiple fractures and open wounds provided a unique opportunity to practice damage-control orthopaedics. External fixators remain a time-tested tools for operating surgeons on such occasions. The locally manufactured, readily available Naseer-Awais (NA) external fixator filled such needs of this disaster with good outcome.

Methods: This is a retrospective descriptive study of 19,700 patients that presented over seven months to the two centres established by the lead author (SMA) in Muzaffarabad and Mansehra just one night after the 2005 earthquake. A series of local and foreign orthopaedic surgeon teams operated in succession. The computerised patient data collection of 1,145 operations was retrospectively analysed.

Results: Of the 19,700 patients presenting to the SMA centres, 50% had limb injuries. Total fracture fixations were 1,145, of which 295 were external fixations: 185 were applied on the lower limb and 90 on upper limb, the majority were applied on tibia.

Conclusion: External fixators are valuable damage-control tools in natural disasters and warfare injuries. The locally manufactured NA external fixator served the needs of the many limb injuries during the 2005 Pakistan earthquake.

Publication types

  • Multicenter Study

MeSH terms

  • Disasters*
  • Earthquakes*
  • External Fixators / statistics & numerical data*
  • Extremities / surgery
  • Female
  • Fractures, Bone / epidemiology
  • Fractures, Bone / surgery*
  • Humans
  • Male
  • Orthopedic Procedures / instrumentation*
  • Orthopedic Procedures / methods
  • Pakistan / epidemiology
  • Retrospective Studies
  • Treatment Outcome