Epidemiologic Study of Syrian Refugees Underwent Surgery Due to Fracture in a Tertiary Reference Hospital in Turkey

Adem Sahin; Anıl Agar; Cafer Ozgur Hancerli; Bulent Kilic; Deniz Gulabi; Cemil Erturk

doi:10.7759/cureus.13323

Epidemiologic Study of Syrian Refugees Underwent Surgery Due to Fracture in a Tertiary Reference Hospital in Turkey

Cureus. 2021 Feb 13;13(2):e13323. doi: 10.7759/cureus.13323.

Authors

Adem Sahin¹, Anıl Agar², Cafer Ozgur Hancerli³, Bulent Kilic², Deniz Gulabi², Cemil Erturk²

Affiliations

¹ Orthopaedics and Traumatology, Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, TUR.
² Orthopaedics and Traumatology, Saglik Bilimleri University, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR.
³ Orthopaedics, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, TUR.

Abstract

Aim This study aims to analyze the spectrum, management, and outcome of Syrian refugees' fracture over four-year period, highlighting challenges in management and follow-up. Methods This was a retrospective review of Syrian refugee patients operated for fractures at our centre from January 2015 to January 2019. The patients were evaluated for age, gender, mechanism of injury, location and type of fracture, presence of accompanying injuries, surgical technique, complications, mortality and morbidity. The comparison of complications and postop outpatient clinic controls between Turkish citizens and Syrian refugees were also evaluated. Results The study included a total of 455 patients comprising 281 adults (202 males, 79 females) with a mean (SD) age of 41.1 (19.3) years and 174 children with a mean age of 8.8 (4.9) years. The trauma mechanism was most commonly fall in both adult and pediatric patients (86.6% / 73.5%). Whilst lower limb fractures were more common in adults (73.7%), upper limb fractures were more common in children (63.4%). The presence of accompanying trauma was determined in 21 (7.5%) adults and 10 (5.7%) children. Multiple fractures were determined in 12 (4.3%) adults and eight (4.6%) children. Plate fixation (PF) was most used in 137 (48.8%) adult patients and K-wire augmentation was used in 75 (43.1%) pediatric patients. Out of the 455 patients, 41 (14.6%) adults and 13 (7.3%) children developed complications. Whilst three adult patients were died during follow-up, no deaths were recorded in the pediatric patients. Complication rate was 54/455 in Syrian refugees and 32/455 in citizens. It was observed that the complication was significantly higher in immigrants (p: 0.017). Sixty-five (14.2%) Syrian immigrants did not come to the outpatient clinic control at all or once, while this rate was 29/455 (6.3%) for Turkish citizens (p = 0.012). Conclusion Inadequate living conditions and lack of communication faced by refugees reduce the rate of patient follow-up and negatively affect the results of orthopedic trauma.

Keywords: epidemiology; fracture; operation; syrian refugees.