ABSTRACT
PURPOSE: In orthopedics and traumatology, as a direct consequence of the COVID-19 first wave, there was a massive reorganization and a stop to all elective activities, which were postponed. In this study, we aimed to analyze the impact of the COVID-19 pandemic on orthopedic surgery in Apulia during the second wave, from March to June 2021 (when Apulia was under social distancing restrictions), and during the third wave, from September to December 2021 (when Apulia was under no restrictions). We compared these months to the same periods in 2019 for an evaluation of the surgical decrease during the pandemic period. METHODS: We performed a retrospective analysis of major orthopedic procedures, day-surgery procedures and urgent procedures (trauma and non-traumatic amputation) performed during the second and third waves of the pandemic in our clinic, and we compared these data with the same procedures performed in the corresponding periods of 2019, before the pandemic. RESULTS: Surgical activity was significantly decreased during both periods; the only increase in surgical activity in 2021 compared to 2019 was in total hip, knee and shoulder arthroplasty, with a surge of +7.69% registered in the period September-December 2021. CONCLUSIONS: Longer waiting lists and limited healthcare resources were the big challenges for the orthopedic community, and they still represent a substantial issue to confront today.
ABSTRACT
PURPOSE: The national lockdown established by the Italian government began on the 11th of March 2020 as a means to control the spread of SARS-CoV-2 infections. The purpose of this brief report is to evaluate the effect of the national lockdown on the occurrence and characteristics of trauma in children during lockdown. METHODS: All children admitted to our paediatric orthopaedic unit with a diagnosis of fracture or trauma, including sprains and contusions, between 11 March 2020 and 11 April 2020, were retrospectively reviewed. Their demographic data, type of injury, anatomical location and need for hospitalisation were compared with the equivalent data of children admitted for trauma in the same period of 2018 and 2019. RESULTS: Sixty-nine patients with trauma were admitted in 2020, with a significant decrease in comparison with 2019 (n = 261) and 2018 (n = 289) (p < 0.01). The patients were significantly younger, and the rate of fractures significantly increased in 2020 (p < 0.01). CONCLUSIONS: Home confinement decreased admissions to the emergency department for trauma by shutting down outdoor activities, schools and sports activities. However, the rate of fractures increased in comparison with minor trauma, involved younger children and had a worse prognosis.
ABSTRACT
BACKGROUND: From February 21, the day of hospitalisation in ICU of the first diagnosed case of Covid-19, the social situation and the hospitals' organisation throughout Italy dramatically changed. METHODS: The CIO (Club Italiano dell'Osteosintesi) is an Italian society devoted to the study of traumatology that counts members spread in public and private hospitals throughout the country. Fifteen members of the CIO, Chairmen of 15 Orthopaedic and Trauma Units of level 1 or 2 trauma centres in Italy, have been involved in the study. They were asked to record data about surgical, outpatients clinics and ER activity from the 23rd of February to the 4th of April 2020. The data collected were compared with the data of the same timeframe of the previous year (2019). RESULTS: Comparing with last year, overall outpatient activity reduced up to 75%, overall Emergency Room (ER) trauma consultations up to 71%, elective surgical activity reduced up to 100% within two weeks and trauma surgery excluding femoral neck fractures up to 50%. The surgical treatment of femoral neck fractures showed a stable reduction from 15 to 20% without a significant variation during the timeframe. CONCLUSIONS: Covid-19 outbreak showed a tremendous impact on all orthopaedic trauma activities throughout the country except for the surgical treatment of femoral neck fractures, which, although reduced, did not change in percentage within the analysed timeframe.