The 14 July 2016 terrorist attack in Nice: The experience of orthopaedic surgeons.
Adolescent
Adult
Aged
Aged, 80 and over
Diaphyses
/ injuries
Female
Fractures, Bone
/ surgery
Fractures, Open
/ surgery
France
Humans
Injury Severity Score
Joints
/ injuries
Male
Mass Casualty Incidents
Middle Aged
Motor Vehicles
Multiple Trauma
/ surgery
Retrospective Studies
Time-to-Treatment
/ statistics & numerical data
Young Adult
Damage control orthopaedics
Mass casualty events
Osteo-articular injuries
Terrorist attack
Journal
Orthopaedics & traumatology, surgery & research : OTSR
ISSN: 1877-0568
Titre abrégé: Orthop Traumatol Surg Res
Pays: France
ID NLM: 101494830
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
06
09
2018
revised:
03
02
2019
accepted:
05
02
2019
pubmed:
1
4
2019
medline:
23
2
2020
entrez:
1
4
2019
Statut:
ppublish
Résumé
On 14 July 2016, a terrorist drove a truck through the crowd on the Promenade des Anglais in Nice, France, killing 87 people and injuring 458. The objective of this study was to evaluate the management strategy used to handle the osteo-articular injuries caused by this attack. The management strategy used ensured that open fractures were treated within 6hours. This single-centre retrospective study included all victims of the attack admitted to the Pasteur 2 Hospital in Nice, France, for osteo-articular injuries, and treated between 14 and 31 July 2016. The following data were collected for each patient: age, sex, type of injury, Injury Severity Score (ISS), whether the damage control orthopaedics (DCO) or early total care (ETC) approach was followed, time from injurytotreatment, operative time, and surgical revisions. The primary outcome measure was the injury to treatment time for each lesion. Of the 182 patients admitted to the emergency department, 32 required admission for osteo-articular injuries, including 18 with severe injuries (ISS>15) and 11 with multiple fractures. Their injuries were of the type seen in traffic accidents. Of the 87 fractures, 45% involved the lower limbs and 25% were open fractures. Surgery was performed in 14 patients on the first night (14 to 15 July) and in 19 patients overall. The approach was DCO in 12 and ETC in 7 of these 19 patients. All lesions were managed within recommended time intervals, including the 21 open fractures and 2 closed femoral shaft fractures. Injury-to-surgery time complied with recommendations in all cases. In 25% of cases, ETC would have been feasible during the mass influx of patients without hospital capacity saturation. IV, retrospective observational study.
Sections du résumé
BACKGROUND
On 14 July 2016, a terrorist drove a truck through the crowd on the Promenade des Anglais in Nice, France, killing 87 people and injuring 458. The objective of this study was to evaluate the management strategy used to handle the osteo-articular injuries caused by this attack.
HYPOTHESIS
The management strategy used ensured that open fractures were treated within 6hours.
MATERIAL AND METHOD
This single-centre retrospective study included all victims of the attack admitted to the Pasteur 2 Hospital in Nice, France, for osteo-articular injuries, and treated between 14 and 31 July 2016. The following data were collected for each patient: age, sex, type of injury, Injury Severity Score (ISS), whether the damage control orthopaedics (DCO) or early total care (ETC) approach was followed, time from injurytotreatment, operative time, and surgical revisions. The primary outcome measure was the injury to treatment time for each lesion.
RESULTS
Of the 182 patients admitted to the emergency department, 32 required admission for osteo-articular injuries, including 18 with severe injuries (ISS>15) and 11 with multiple fractures. Their injuries were of the type seen in traffic accidents. Of the 87 fractures, 45% involved the lower limbs and 25% were open fractures. Surgery was performed in 14 patients on the first night (14 to 15 July) and in 19 patients overall. The approach was DCO in 12 and ETC in 7 of these 19 patients. All lesions were managed within recommended time intervals, including the 21 open fractures and 2 closed femoral shaft fractures.
DISCUSSION
Injury-to-surgery time complied with recommendations in all cases. In 25% of cases, ETC would have been feasible during the mass influx of patients without hospital capacity saturation.
LEVEL OF EVIDENCE
IV, retrospective observational study.
Identifiants
pubmed: 30928274
pii: S1877-0568(19)30066-0
doi: 10.1016/j.otsr.2019.02.009
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
505-511Informations de copyright
Copyright © 2019 Elsevier Masson SAS. All rights reserved.