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1.
Knee Surg Sports Traumatol Arthrosc ; 28(6): 1705-1711, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1826407

ABSTRACT

PURPOSE: Due to the lack of evidence, it was the aim of the study to investigate current possible cutbacks in orthopaedic healthcare due to the coronavirus disease 2019 pandemic (COVID-19). METHODS: An online survey was performed of orthopaedic surgeons in the German-speaking Arthroscopy Society (Gesellschaft für Arthroskopie und Gelenkchirurgie, AGA). The survey consisted of 20 questions concerning four topics: four questions addressed the origin and surgical experience of the participant, 12 questions dealt with potential cutbacks in orthopaedic healthcare and 4 questions addressed the influence of the pandemic on the particular surgeon. RESULTS: Of 4234 contacted orthopaedic surgeons, 1399 responded. Regarding arthroscopic procedures between 10 and 30% of the participants stated that these were still being performed-with actual percentages depending on the specific joint and procedure. Only 6.2% of the participants stated that elective total joint arthroplasty was still being performed at their centre. In addition, physical rehabilitation and surgeons' postoperative follow-ups were severely affected. CONCLUSION: Orthopaedic healthcare services in Austria, Germany, and Switzerland are suffering a drastic cutback due to COVID-19. A drastic reduction in arthroscopic procedures like rotator cuff repair and cruciate ligament reconstruction and an almost total shutdown of elective total joint arthroplasty were reported. Long-term consequences cannot be predicted yet. The described disruption in orthopaedic healthcare services has to be viewed as historic. LEVEL OF EVIDENCE: V.


Subject(s)
Coronavirus Infections/epidemiology , Delivery of Health Care/statistics & numerical data , Elective Surgical Procedures/statistics & numerical data , Orthopedic Procedures/statistics & numerical data , Orthopedics/statistics & numerical data , Pneumonia, Viral/epidemiology , Aftercare/statistics & numerical data , Arthroplasty/statistics & numerical data , Arthroscopy/statistics & numerical data , Austria/epidemiology , Betacoronavirus , COVID-19 , Coronavirus Infections/virology , Germany/epidemiology , Health Care Surveys , Humans , Internet , Male , Pandemics/statistics & numerical data , Pneumonia, Viral/virology , Rehabilitation/statistics & numerical data , SARS-CoV-2 , Switzerland/epidemiology
2.
J Pediatr Orthop ; 42(Suppl 1): S8-S12, 2022.
Article in English | MEDLINE | ID: covidwho-1784405

ABSTRACT

The past decade has seen a shift in health care delivery models to be more value-based: patient-centered, accessible, and cost-effective. One of the primary modes of addressing these needs has been through the implementation of telemedicine-digital health care technology that streamlines and enhances traditional health care delivery. In the orthopaedic setting, there are various methods of telemedicine utilization, each uniquely optimized for different clinical scenarios. There are certain financial and technological limitations when utilizing telemedicine for orthopaedic care that pose notable barriers to uniform utilization across the specialty. Nonetheless, these challenges are currently being tested as orthopaedic surgeons continuously become more innovative and creative as to how they deliver care. As we enter our "new normal" in the post-COVID-19 era, the availability and use of telemedicine will equip orthopaedic surgeons to deliver high-quality, affordable, and accessible care in an ever-changing health care landscape.


Subject(s)
COVID-19 , Orthopedics , Telemedicine , Biomedical Technology , Humans , Patient Care
4.
J Am Acad Orthop Surg Glob Res Rev ; 6(2)2022 02 11.
Article in English | MEDLINE | ID: covidwho-1687332

ABSTRACT

INTRODUCTION: Stay-at-home orders and other social distancing restrictions had a profound effect on the lives of children during the pandemic. This study characterizes pediatric orthopaedic injuries and in-hospital outcomes during the COVID-19 pandemic and compares them with pre-COVID patterns. METHODS: A retrospective review of pediatric patients presenting to hospitals with Pennsylvania Trauma Systems Foundation designations was performed. All patients younger than 18 years who presented with orthopaedic injuries were included. Patient demographics, injuries, hospital stays, and mortality were compared between the COVID and pre-COVID cohorts. RESULTS: Overall, 1112 patients were included. During the pandemic, more injuries occurred at home (44.7% versus 54.9%, P = 0.01) and fewer at sporting areas, parks, and pools (7.8% versus 1.6%, P < 0.01) as well as at schools (3.4% versus 0.5%, P = 0.03). Injuries caused by child abuse were more prevalent during the pandemic (5.6% versus 11.0%, P < 0.01). Finally, the COVID cohort had a longer mean hospital length of stay (3.1 versus 2.4 days, P = 0.01), higher mean number of ICU days (1.0 versus 0.7 days, P = 0.02), and higher mortality rate (3.8% versus 1.3%, P = 0.02). DISCUSSION: Pediatric patients sustained injuries in differing patterns during the pandemic, but these led to worse hospital outcomes, including higher mortality rates.


Subject(s)
COVID-19 , Orthopedics , Child , Humans , Pandemics , Retrospective Studies , SARS-CoV-2 , Trauma Centers
5.
J Pediatr Orthop ; 42(4): 233-238, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1649226

ABSTRACT

BACKGROUND: Social media has grown significantly and its application in health care has been dramatically accentuated by the COVID-19 pandemic. It is often considered as a "new dimension" of health care, particularly in its ability to provide health information. In 2017, the top social media sites utilized by pediatric orthopaedic surgeons included Facebook, LinkedIn, and Twitter. In our study, we analyze the current social media usage, trends in Instagram and TikTok content, and the perceptions on social media usage among pediatric orthopaedic surgeons. METHODS: The Pediatric Orthopaedic Society of North America (POSNA) membership directory was searched for the presence of social media. A review of all Instagram and TikTok posts made by the POSNA members were reviewed. A survey regarding the perception of social media networks and content was distributed to all POSNA members. RESULTS: A total of 1231 POSNA members actively practicing in the United States were included in our study. In all, 327 (26.6%) had a LinkedIn profile, 34 (2.8%) had a professional Facebook profile, 15 (1.2%) had a public Instagram account, 0 (0%) had TikTok, and 72 (5.8%) had a professional Twitter account. Fifteen POSNA members with public Instagram accounts had 10,878 followers. A total of 907 Instagram posts were made, 134 (14.8%) of which were education and 462 (50.9%) of which were personal or political. The perception of various social media networks such as Instagram (3.02), Facebook (3.16), and LinkedIn (3.51) were positive on a 5-point Likert scale, while perceptions of TikTok (2.36) and Twitter (2.99) were negative. Educational posts on Instagram (3.19) and Facebook (3.37) were positive. CONCLUSIONS: We provide an update to the utilization of social media by pediatric orthopaedists. Use of Instagram and TikTok accounts remain rare. Educational posts, when hosted on an appropriate social media platform, are perceived positively among pediatric orthopaedists. LEVEL OF EVIDENCE: Level IV.


Subject(s)
COVID-19 , Orthopedics , Social Media , Child , Humans , Pandemics , SARS-CoV-2 , United States
6.
Ital J Pediatr ; 47(1): 232, 2021 Dec 07.
Article in English | MEDLINE | ID: covidwho-1630738

ABSTRACT

In this article, we describe the advances in the field of pediatrics that have been published in the Italian Journal of Pediatrics in 2020. We report progresses in understanding allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, orthopedics, respiratory tract illnesses, rheumatology in childhood.


Subject(s)
Pediatrics/trends , COVID-19 , Child Nutrition Sciences , Critical Care , Endocrinology , Gastrointestinal Microbiome , Humans , Hypersensitivity , Infectious Disease Medicine , Neonatology , Neurology , Orthopedics , Rare Diseases , Respiratory Tract Diseases , Rheumatology
7.
J Am Acad Orthop Surg Glob Res Rev ; 6(1)2022 01 19.
Article in English | MEDLINE | ID: covidwho-1639304

ABSTRACT

INTRODUCTION: When the COVID-19 pandemic forced the cancellation of visiting subinternships, we pivoted to create a virtual orthopaedic rotation (VOR). The purpose of this study was to assess the effect of the VOR on the residency selection process and determine the role of such a rotation in the future. METHODS: A committee was convened to create a VOR to replace visiting orthopaedic rotations for medical students who are interested in pursuing a career in orthopaedic surgery. The VOR was reviewed and sanctioned by our medical school, but no academic credit was granted. We conducted three 3-week VOR sessions. During each session, virtual rotators participated in regularly scheduled educational conferences and attended an invitation-only daily conference in the evenings that was designed for a medical student audience. In addition, students were paired with faculty and resident mentors in a structured mentorship program. Students' orthopaedic knowledge was assessed using prerotation and postrotation tests. RESULTS: From July to September 2020, 61 students from 37 distinct medical schools participated in the VOR. Notable improvements were observed in prerotation and postrotation orthopaedic knowledge test scores. In postrotation surveys, both students and faculty expressed high satisfaction with the curriculum but less certainty about how well they got to know each other. In the subsequent residency application cycle, 27.9% of the students who participated in the VOR were selected to interview, compared with 8.7% of the total application pool. DISCUSSION: The VOR was a valuable substitute for in-person clinical rotations during the COVID-19 pandemic. Although not likely to be a replacement for conventional away rotations, the VOR is a possible adjunct to in-person clinical rotations in the future.


Subject(s)
COVID-19 , Internship and Residency , Orthopedics , Humans , Orthopedics/education , Pandemics , SARS-CoV-2
8.
BMJ Open ; 12(1): e054919, 2022 01 18.
Article in English | MEDLINE | ID: covidwho-1638096

ABSTRACT

OBJECTIVE: This is the first British multicentre study observing the impact of the COVID-19 pandemic on orthopaedic trauma with respect to referrals, operative caseload and mortality during its peak. DESIGN: A longitudinal, multicentre, retrospective, observational, cohort study was conducted during the peak 6 weeks of the first wave from 17 March 2020 compared with the same period in 2019. SETTING: Hospitals from six major urban cities were recruited around the UK, including London. PARTICIPANTS: A total of 4840 clinical encounters were initially recorded. 4668 clinical encounters were analysed post-exclusion. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes included the number of acute trauma referrals and those undergoing operative intervention, mortality rates and the proportion of patients contracting COVID-19. Secondary outcomes consisted of the mechanism of injury, type of operative intervention and proportion of aerosolising-generating anaesthesia used. RESULTS: During the COVID-19 period, there was a 34% reduction in acute orthopaedic trauma referrals compared with 2019 (1792 down to 1183 referrals), and a 29.5% reduction in surgical interventions (993 down to 700 operations). The mortality rate was more than doubled for both risk and odds ratios during the COVID-19 period for all referrals (1.3% vs 3.8%, p=0.0005) and for those undergoing operative intervention (2.2% vs 4.9%, p=0.004). Moreover, mortality due to COVID-19-related complications (vs non-COVID-19 causes) had greater odds by a factor of at least 20 times. For the operative cohort during COVID-19, there was an increase in odds of aerosolising-generating anaesthesia (including those with superimposed regional blocks) by three-quarters, as well as doubled odds of a consultant acting as the primary surgeon. CONCLUSION: Although there was a reduction of acute trauma referrals and those undergoing operative intervention, the mortality rate still more than doubled in odds during the peak of the pandemic compared with the same time interval 1 year ago.


Subject(s)
COVID-19 , Orthopedics , Cohort Studies , Humans , Pandemics , Referral and Consultation , Retrospective Studies , SARS-CoV-2 , United Kingdom/epidemiology
9.
J Am Acad Orthop Surg Glob Res Rev ; 6(1)2022 01 19.
Article in English | MEDLINE | ID: covidwho-1636841

ABSTRACT

INTRODUCTION: Grand rounds have been weekly gatherings at academic orthopaedic surgery programs across the country for decades. During the 50th year of grand rounds at our institution, the COVID-19 pandemic prompted the transformation of this in-person forum into a virtual setting. The purpose of this study was to detail this initiative and to report survey data providing participant-reported perceptions and satisfaction of virtual versus in-person grand rounds. MATERIALS AND METHODS: Once in-person meetings were discontinued, virtual grand rounds commenced using the Zoom video application. At the conclusion of the 2020 to 2021 academic year, a 30-item online survey was sent to all residents, faculty, and visiting faculty to assess their perspective and satisfaction. A five-point Likert scale ranging from 1 to 5, with 5 being extremely effective, was used. A 21-item follow-up survey was sent to all speakers as well. RESULTS: Thirty-six virtual grand rounds were successfully hosted. The response rate for the survey was excellent-80 of 86 (93.0%) surveys returned completed. Respondents found that virtual grand rounds were more convenient to attend, were more convenient to obtain Continuing Medical Education, and were more satisfied with virtual grand rounds. Respondents reported that in-person grand rounds were more effective for stimulating social collegiality and networking. Speakers found that virtual grand rounds were more effective for uploading the presentation and overall convenience, whereas they were less effective at retaining audience attention and receiving audience feedback. Improved faculty attendance after the switch to virtual grand rounds was also noted. CONCLUSION: This study found that respondents across all groups appreciated the convenience of attending and obtaining Continuing Medical Educations at virtual grand rounds while also noting the merits of in-person grand rounds for promoting peer interaction, camaraderie, and departmental identity. All respondents strongly recommended continuation of this program in a hybrid format. Virtual orthopaedic grand rounds are viable, readily implemented and demonstrate improved participant satisfaction.


Subject(s)
COVID-19 , Internship and Residency , Orthopedic Procedures , Orthopedics , Teaching Rounds , Humans , Pandemics , Patient Reported Outcome Measures , SARS-CoV-2 , Surveys and Questionnaires
11.
Ulus Travma Acil Cerrahi Derg ; 28(1): 27-32, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1596690

ABSTRACT

BACKGROUND: With the rapid and effective change created by the COVID-19 pandemic in all medical practice, we aimed to evaluate the impact of the first 100 days of the COVID-19 pandemic on the operations performed in a reference university hospital in the field of orthopedics and traumatology. Compare the results with the same period of the previous year and aim to evaluate importance of restrictions. METHODS: The operations performed in orthopedics and traumatology clinic between March 18, 2020 (the day we stopped the elective surgeries), and July 1, 2020 (when the normalization process began), were collected from the electronic archive to compare with the same period of 2019. RESULTS: Comparing the same periods of the year, it was seen that 102 surgeries were performed in the 2020 COVID-19 period compared to 380 operations performed in 2019. Although most of the operations performed during the COVID-19 period were traumas, the comparison revealed that trauma cases decreased by 25% from 73 to 58 (p<0.001). Among trauma patients operated in the restraint period, decrease in the pediatric group and the increase in patients over 65 years of age had seen statistically significant. Compared to the same period of the previous year, 50% increase seen in amputation cases related to diabetic foot (p<0.001). CONCLUSION: The postponement of elective cases due to the COVID-19 pandemic enabled us to manage trauma cases despite decreasing capacity utilization. In addition, it was observed that the transition of schools to online education and the implementation of curfews significantly reduced the number of trauma in the pediatric group. Separation of operating rooms and wards had a huge effect on protection of non-COVID patients. We hope that, in light of this study, we can guide health policies and help other colleagues to manage the possible new waves of the pandemic process or similar processes that may occur in the future.


Subject(s)
COVID-19 , Orthopedics , Child , Hospitals, University , Humans , Pandemics , SARS-CoV-2
12.
J Orthop Sci ; 27(2): 297-298, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1587178

ABSTRACT

The pandemic of the new coronavirus infection has swept the world and killed more than 5 million people, which has shocked all human beings who have believed in modern medical progress. Along with the sedation of infections, the balance between restriction and acceleration of socio-economic activities is difficult. With the spread of vaccines and the advent of viral therapeutic agents, we expect how to control this pandemic has finally become visible. In this situation, we realize that data science and robotics innovations are quite important in many medical fields. Artificial intelligence (AI) diagnosis and remote medical care are becoming a reality, and this direction will accelerate further in 2022, the first year of post-pandemic. The trend of digital transformation (Dx) will also be rushing into Orthopedics next year. In addition, research on virtual reality and augmented reality is being actively conducted, and it has become possible to use it for surgical simulation and technical training. As, in the field of abdominal surgery, remote robotic surgery will soon become available in the field of orthopedics as well. These Dx trend will prevail to our field instead of experience, and knowledge of medicine, which can change the medical care style dramatically in near future. It is crucial for orthopedic surgeons to always aim for its development and evolution.


Subject(s)
COVID-19 , Orthopedic Procedures , Orthopedics , Artificial Intelligence , Humans , Pandemics/prevention & control
13.
J Orthop Surg (Hong Kong) ; 29(3): 23094990211066131, 2021.
Article in English | MEDLINE | ID: covidwho-1582477

ABSTRACT

OBJECTIVES: Lockdowns have been implemented by countries to slow down SARS-CoV-2 transmission. Singapore's lockdown was enforced between 7 April 2020 and 1 June 2020. The objective of this study was to compare the epidemiology of paediatric orthopaedic trauma injuries during and immediately after the lockdown, with a non-pandemic period in 2019. METHODS: All paediatric outpatients and inpatients seen in our hospital following an orthopaedic-related traumatic injury from the 8-week lockdown and 8 weeks post-lockdown were evaluated. Cases for matched periods in 2019 were identified retrospectively for baseline comparison. Patient demographics, venue of injury, anatomic location of injury, caregiver supervision and location of procedures performed in the hospital were assessed. RESULTS: 968 and 2810 injuries were observed in 2020 and 2019, respectively. While the proportion of injuries sustained by pre-schoolers and toddlers increased, those sustained by primary and secondary school children decreased in 2020 (p < 0.001). Majority of the injuries during the lockdown were sustained at home compared to schools or public recreational facilities (p < 0.001). Hand (26.2%) and elbow (20.8%) injuries were the most common during the lockdown. The proportion of procedures performed in the Children's Emergency during the lockdown was more than twice that of the same period in 2019 (p < 0.001). CONCLUSION: Our study showed a 2.9-fold decrease in orthopaedic-related injuries seen during the peri-lockdown period compared to a non-pandemic period. Pre-schoolers seem to be most vulnerable to injuries during the lockdown. Hand and elbow injuries were most common.


Subject(s)
COVID-19 , Orthopedics , Child , Communicable Disease Control , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
14.
J Pediatr Orthop B ; 31(1): e75-e80, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1570111

ABSTRACT

The purpose of this study is to evaluate usability and patient satisfaction with telemedicine in pediatric orthopedics using validated questionnaires and to identify demographic and clinical factors that may impact these ratings. All caregivers of patients who had telemedicine visits with a single fellowship-trained pediatric orthopedic surgeon between 23 March 2020 and 3 June 2020 were eligible to participate. Patient Satisfaction Questionnaire (PSQ) and the Telehealth Usability Questionnaire (TUQ) rated on a 4-point Likert scale (1 = poor, 2 = fair, 3 = good and 4 = excellent) were used. Additional information regarding the level of education, mode of transportation, technology usage, demographics, visit diagnosis and length of visit were collected. Quantitative analysis was performed. A total of 68.6% (83/121) of the visits were done via telemedicine. Around 46 surveys were completed with a response rate of 55.4% (46/83). The PSQ mean score was 3.63 ± 0.39 with non-English-speaking caregivers scoring lower compared to their English-speaking counterparts (3.4 ± 0.47 vs. 3.72 ± 0.33; P = 0.017). PSQ mean score increased with increasing length of visit (r = 0.352; P = 0.018). A total of 86.8% (839/966) of all TUQ's responses were good to excellent with 89.1% (41/46) of responders were satisfied with telemedicine and 91.3% (42/46) would use it again. Although the topic is an evolving one, and a lot of changes should be expected in the future, certain characteristics such as primary language and length of visit may affect the levels of satisfaction with the use of telemedicine in pediatric orthopedics. Knowledge regarding satisfaction ratings may allow orthopedic surgeons to improve patient care delivered through this technology. Level of Evidence: IV.


Subject(s)
COVID-19 , Orthopedics , Telemedicine , Child , Humans , Patient Satisfaction , Personal Satisfaction
16.
J Pediatr Orthop B ; 31(1): e69-e74, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1561345

ABSTRACT

Telehealth services are innovative healthcare strategies that utilize communication technologies to improve healthcare access for patients. Teleradiology is a form of telehealth service that involves the transmission of radiological images, such as x-rays, CTs and MRIs, from one location to another to share patient information with other physicians. The purpose of this study was to assess teleradiology consultations for orthopaedic patients at a paediatric tertiary care centre. A retrospective review was conducted of patients who received teleradiology consultations with a single orthopaedic surgeon from 2015 to 2018 through the paediatric orthopaedic hip clinic at our institution. Teleradiology consultations involved follow-up radiographic imaging at a local community facility for patients who initially received healthcare services at our institution, followed by a telephone consultation to review imaging results and communicate next steps in care. Data collected included patient demographics, imaging type, facility location and distance from our institution. Eighty patients (F = 66, M = 14) who received teleradiology services were reviewed. Mean age was 3.5 years [95% confidence interval (CI): 2.5-4.4] at time of imaging. The average distance from community facilities to our institution was 1167 km (95% confidence interval: 920-1414), a measure of the total distance saved in travel for each patient in a single direction. The travel distance saved was substantial. Paediatric orthopaedic teleradiology services provide families specialized consultations and care continuity without costly travel. With increased implementation of teleradiology services, more patients and families can remain in their home communities while receiving the same quality of care.


Subject(s)
Orthopedics , Teleradiology , Child , Child, Preschool , Humans , Referral and Consultation , Retrospective Studies , Telephone , Tertiary Care Centers
17.
Br J Nurs ; 30(20): 1178-1183, 2021 Nov 11.
Article in English | MEDLINE | ID: covidwho-1524632

ABSTRACT

BACKGROUND: Clinical nurse specialists (CNSs) are experienced senior nurses with advanced clinical knowledge, communication and leadership skills and commonly take on extended roles to optimise care delivery within health and social care. AIM: To critically explore the experience of one clinical nurse specialist who undertook an enhanced qualification to become a surgical first assistant. METHODS: A case-study approach based on Gibbs' reflective model is used to reflect on the experience, its benefits to patient care and the challenges and facilitators related to taking on advanced surgical roles. FINDINGS: Long-term benefits can be achieved by investing in CNSs educated to hold the enhanced surgical first assistant qualification. Advanced roles enhance evidence-based service delivery, while also benefitting the clinical nurse specialist, the patient and the trust.


Subject(s)
Nurse Clinicians , Orthopedics , Hospitals , Humans , Leadership
18.
World J Surg ; 46(1): 10-18, 2022 01.
Article in English | MEDLINE | ID: covidwho-1505978

ABSTRACT

BACKGROUND: The objective of this study was to evaluate the current body of evidence on the use of telemedicine in surgical subspecialties during the COVID-19 pandemic. METHODS: This was a scoping review conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). MEDLINE via Ovid, PubMed, and EMBASE were systematically searched for any reports discussing telemedicine use in surgery and surgical specialties during the first period (February 2020-August 8, 2020) and second 6-month period (August 9-March 4, 2021) of the COVID-19 pandemic. RESULTS: Of 466 articles screened through full text, 277 articles were included for possible qualitative and/or quantitative data synthesis. The majority of publications in the first 6 months were in orthopedic surgery, followed by general surgery and neurosurgery, whereas in the second 6 months of COVID-19 pandemic, urology and neurosurgery were the most productive, followed by transplant and plastic surgery. Most publications in the first 6 months were opinion papers (80%), which decreased to 33% in the second 6 months. The role of telemedicine in different aspects of surgical care and surgical education was summarized stratifying by specialty. CONCLUSION: Telemedicine has increased access to care of surgical patients during the COVID-19 pandemic, but whether this practice will continue post-pandemic remains unknown.


Subject(s)
COVID-19 , Orthopedics , Telemedicine , Humans , Pandemics , SARS-CoV-2
19.
Acta Orthop Traumatol Turc ; 55(5): 391-395, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1502686

ABSTRACT

OBJECTIVE: The aim of this study was to compare the characteristics and distribution of trauma surgeries performed in the first phase of the COVID-19 pandemic, the second phase of the pandemic, and the normal period before the pandemic. METHODS: Three different time periods were determined.Group 1 represented the first wave of the pandemic, in which lockdowns andrestrictions were strictly applied and only emergency and trauma surgeries wereperformed, between 1 April and 31 May 2020. Group 2 represented the second waveof the pandemic, during which restrictions were not applied and only emergencyand trauma surgeries were performed, from 1 September to 31 October 2020. Group3 represented the normal period before the pandemic, including surgeriesperformed between 1 September and 31 October 2019. In addition, patients ineach group were divided into two groups as younger than 16 or older than 16 inorder to understand the difference between paediatric and adult orthopaedictraumas. The distribution of patients and their fractures were evaluated. RESULTS: In Group 1, the rates of intra-articular fractures, distal extremity fractures, and proximal humerus fractures decreased, while the rate of proximal femur fractures increased (P < 0.05 for all). The frequency of hand fractures treated in Groups 1 and 2 compared to Group 3 was reduced (P < 0.05 for both). There was no statistically significant difference between Groups 2 and 3 for fractures in different parts of the body except for hand fractures (P = 0.001 for hand fractures, P > 0.05 for the other fractures). CONCLUSION: We observed that the frequency of fractures decreased, and the distribution changed due to severe restrictions and lockdowns in the first wave of the pandemic. When the restrictions and lockdowns were removed in the second wave, the frequency of fractures decreased, but the distribution of fractures was similar to the normal period in 2019. LEVEL OF EVIDENCE: Level III, Diagnostic Study.


Subject(s)
COVID-19 , Orthopedics , Adult , Child , Communicable Disease Control , Humans , Pandemics , Retrospective Studies , SARS-CoV-2 , Trauma Centers
20.
ANZ J Surg ; 92(1-2): 206-211, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1494595

ABSTRACT

BACKGROUND: From 26 March 2020, New Zealand implemented a COVID-19 elimination strategy which initially involved substantive limitations on public movement and assembly, and closure of non-essential businesses. We asked what effect this had on acute paediatric orthopaedic presentations to a tertiary children's hospital. METHOD: The numbers, age and gender of patients with orthopaedic presentations, seen by either the Children's Emergency Department (CED) or the orthopaedic service during the study period, were compared with the equivalent 2019 period. RESULTS: During the first 64 days of lockdown, 708 patients were seen in CED with orthopaedic presentations compared with 1124 patients in the same period in 2019 (37% reduction). We found a 55% reduction in musculoskeletal infections (from 135 to 61), a 40% reduction in total fractures (from 446 to 268) and a 27% reduction in soft tissue injuries (from 520 to 380). In 2020, similar proportions of patients were admitted for operating room procedures (15%) or had fractures reduced under sedation in CED (17%), however, increased numbers of soft tissue injuries were managed through CED under procedural sedation. CONCLUSION: A national COVID-19 elimination strategy, closing all but essential businesses, limiting public movement, physical distancing and focusing on hand hygiene, led to reduced presentations not only with fractures and soft tissue injuries but also musculoskeletal infections. Increased numbers of patients had procedural sedation for soft tissue injuries, but there was no significant change in the proportion of patients admitted for surgery.


Subject(s)
COVID-19 , Orthopedics , COVID-19/epidemiology , COVID-19/prevention & control , Child , Communicable Disease Control , Emergency Service, Hospital , Hospitals, Pediatric , Humans , Retrospective Studies , SARS-CoV-2
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