Twisters result in multiple musculoskeletal injuries

On the evening of Tuesday, Feb. 5, 2008, an estimated 80 tornadoes tore through parts of Alabama, Arkansas, Florida, Georgia, Kentucky, and Tennessee. During this worst tornado outbreak in the United States in 20 years, violent winds uprooted trees, flattened buildings, upended cars, and killed or injured at least 55 people.

One of the hardest hit cities—Jackson, Tenn.—is home to West Tennessee Bone & Joint Clinic. The practice is located just one-quarter mile from the campus of Union University, much of which was pulverized by the storms. Experiencing the brutal force of the tornadoes was a harrowing experience for everyone, including the clinic’s orthopaedists and their patients.

Riding out the storm
Around 6 p.m. that night, the clinic’s physicians and staff gathered at the office for a regularly scheduled meeting. They quickly adjourned when they heard the urgent tornado warning.

L. David Johnson, MD, found 15 friends and family members taking cover in the basement of his home.

“It was about 7:10 p.m. when the storm actually hit,” he recalls. “The lights flickered as the power switched over to the generator. A gust of wind came through the air vents around the perimeter of the basement, blowing my son’s baseball cap off his head. Everybody’s ears were popping.”

Adam M. Smith, MD, also scrambled to get to safety before the storm hit.

“My home is only a mile or so from the major zone of destruction in Jackson,” he said. “We sheltered several neighbors and their children as hail pelted our roof, gutters, and windows.”

The storms uprooted trees and downed power lines. “I counted 32 trees completely uprooted on our 5 acres,” said Dr. Johnson. “One tree came down on the house, and others blocked the driveway.”

Dr. Smith found similar damage to his property.

“Our yard was covered with debris,” he said. “The storm had buried softball-sized hail into the sod like cannon balls. It damaged our roof and gutters and broke some windows, all of which is very minor compared to other folks in our immediate area. We felt very fortunate.”

“Her entire house was blown apart”
With his family safe, Dr. Smith, who was on-call for the practice that day, rushed to Jackson-Madison County General Hospital to join several other physicians in the emergency department.

“The hospital called a ‘Code Black,’ which means all on-call physicians are needed,” said Dr. Smith. Soon after he arrived, the hospital was notified that injured motorists and students from Union University, which had suffered severe damage to 80 percent of its dormitories, were en route.

“More than 20 students were trapped in a caved-in section of the student housing,” he said. “Most students we treated had minor injuries, although at least one patient developed compartment syndrome in his legs after being trapped under debris at the university.”

“It’s unbelievable that no one on campus was killed, because those dorms were filled and the destruction was incredible,” said Dr. Johnson. “Several students had to be cut out of the debris. It was close to midnight before everyone was confirmed out of the damaged area.”

In total, the hospital treated 65 tornado victims, including a patient who was in a closet under a staircase when, in Dr. Smith’s words, “her entire house was blown apart.”

“The patient was thrown more than 100 yards from her home,” he reported. “She sustained pelvic ring fractures, open knee wounds, severe high-energy distal radius fractures, acromioclavicular (AC) joint separation, shrapnel wounds, and finger injuries. She was taken to the operating room for stabilization.”

Another patient sustained an elbow fracture and shoulder AC separation after being thrown from her home, said Dr. Smith.

Getting up and running—and treating patients
The storms barreled through the practice’s parking lot, but left the clinic relatively unscathed. Downed trees damaged the roof, wind gusts blew out windows, and water damaged the hardwood floors in the physical therapy department.

“The four offices next to our building were destroyed,” said Jason T. Hutchison, MD. “In the neighborhood directly behind our office, the houses had severe roof damage and moderate structural damage.”

Although the office was initially without power, a back-up generator helped keep the practice open. The generator also saved the practice’s magnetic resonance imaging machine before its self-cooling system stopped working. By Friday, the practice had full utility service back.

“We all treated patients who had injuries such as broken wrists, sprained ankles, and shoulder injuries that occurred while trying to get out from being pinned under debris,” said Dr. Hutchison.

A community comes together
As a result of the storm, many of Union University’s students lost all their possessions and had nowhere to stay. The clinic’s relationship with the school, based on providing care for the athletes and students, was made even closer when several of the practice’s orthopaedists, including Dr. Hutchison and Harold M. “Trey” Antwine III, MD, opened their homes to students after the storm.

“Many of these kids are from all over the United States,” said Dr. Hutchison. “It was important for us as a community to take care of them like we would want our kids taken care of if they were in similar circumstances.”

According to Dr. Johnson, the entire community pitched in to help after the disaster.

“The day after the storm,” said Dr. Johnson, “we had most of my children’s high school football team in my yard cutting trees and dragging logs all day long. The community, local government, utility company, support services, and Federal Emergency Management Agency all did an incredible job responding to the disaster.

“Traditionally, we’re not thought of as being in tornado alley,” continued Dr. Johnson, “but our city has had three major tornadoes over the last 8 or 9 years. Unfortunately, we’ve had so much experience with them that we’ve become good at handling these kinds of emergencies. It’s not the kind of experience anyone wants to have.”

Jennie McKee is a staff writer for AAOS Now. She can be reached at mckee@aaos.org