Abstract
AimThis study aims to analyze the spectrum, management, and outcome of Syrian refugees’ fracture over four-year period, highlighting challenges in management and follow-up.MethodsThis 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.ResultsThe 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).ConclusionInadequate living conditions and lack of communication faced by refugees reduce the rate of patient follow-up and negatively affect the results of orthopedic trauma.
Highlights
Since the beginning of the Syrian conflict in March 2011, more than 10 million Syrians have had to leave their homes and country and have sought refuge in neighboring countries [1]
This was a retrospective review of Syrian refugee patients operated for fractures at our centre from January 2015 to January 2019
Whilst lower limb fractures were more common in adults (73.7%), upper limb fractures were more common in children (63.4%)
Summary
Since the beginning of the Syrian conflict in March 2011, more than 10 million Syrians have had to leave their homes and country and have sought refuge in neighboring countries [1]. Turkey is hosting 3.5 million people, which is the largest number of refugees in the world [2]. There was a low rate of utilization of healthcare services by the Syrian refugees living outside the camps, which could be attributed to insufficient information about how to use the healthcare services in Turkey, communication barriers or lack of a state-issued identity number [4]. Over the years, such problems have been resolved with the adaptation process, language learning and the help of the state.
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