To Evaluate the Functional Outcome of Intertrochanteric Fracture Treated by PFNA2 in COVID-19-Positive Patients: A Retrospective Study

ABSTRACT

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-also known as 2019 novel coronavirus or COVID-19-first emerged on December 31, 2019 in China, and has since rapidly spread to become a world-wide pandemic. Orthopaedic trauma services, have maintained a significant portion of their previous volume throughout the pandemic, specifically, hip fractures in the elderly population.Intertrochanteric fracture is one of the most common injuries among the elderly and is associated with a high mortality rate within 30 days after the injury event.Treatment of Intertrochanteric fractures during the coronavirus disease 2019 (COVID-19) pandemic has posed unique challenges for the management of COVID-19infected patients and the maintenance of standards of care. PFNA2 provide stability, compression as well as rotational control of the fracture and allows early post operative mobilization, weight bearing and thereby early fracture union. This study aims to assess the functional outcome of intertrochanteric fracture treated by PFNA2 in COVID-19-positive patients. Objectives: To evaluate the functional outcome of intertrochanteric fracture treated by PFNA2 in COVID-19-positive patients a retrospective study Methodology: This was a retrospective study of 30 patients,18 females and 12 males ≥55 years of age with intertrochanteric fracture and COVID-19 who underwent operative management with PFNA2. Clinical characteristics and early postoperative outcomes were reported. Results: A total of 30 patients, 21 patients (70%) had fever, cough, and fatigue at the time of presentation. 9 patients (30%) had sore throat and dyspnea, headache and dizziness (23%) (7 patients), abdominal pain and vomiting (16%) (5 patient), chest pain and nasal congestion (10%) (3 patient).18 patients (60%) had comorbidities. Postoperatively all 30 patients (100%) required non-invasive mechanical ventilation. All patients (100%) were given antibiotic therapy,18 patients underwent anti thromboembolic prophylaxis. 20 patients were treated with corticosteroids. Blood transfusion was done in 14 patients. Average HARRIS HIP SCORE was 83.6 at the end of six months graded as good outcome. The length of hospital stay in our study was 10 days (7-14 days). The complications in our study included bed sores, superficial and (which settled subsequently with Intravenous antibiotics and debridement respectively). Conclusions: Our study shows that intertrochanteric fracture patients who present with a mild to moderate COVID-19 symptoms who underwent Intertrochanteric fracture surgeries with PFNA2 had a good functional outcome with few post op complications.