Background: The COVID-19 pandemic has already infected more than 3 million people across the world. As the healthworkers man the frontlines, the best practices model is continuously evolving as literature concerning the Coronavirus develops. Methods: A systematic review of the available literature was performed using the keyword terms "COVID-19", "Coronavirus", "surgeon", "health-care workers", "protection" and "Orthopaedic Surgery". All peer-reviewed articles we could find were considered. Randomized controlled trials (RCTs), prospective trials and retrospective studies, as well as reviews and case reports, were included in this systematic review. Results: Even though surgical specialties including orthopedics are on the relative sidelines of the management of this pandemic but best practices models are inevitably developed for surgical specialties. The algorithm of postpone, delay, and operate only when life-threatening conditions exist is going to be useful up to a point. Conclusion: The surgical staff needs to keep abreast of the latest literature concerning safety measures to be taken during surgical procedures. Review articles can go some distance in helping in this educational process. This knowledge must evolve as new information comes to light.

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Objectives?Dislocation of the metacarpophalangeal joint of the thumb in children is an uncommon entity. The aim of this study was to evaluate the clinical outcome of pediatric patients with metacarpophalangeal joint dislocation of the thumb. Patients and Methods?Ten pediatric patients with metacarpophalangeal joint dislocation of the thumb were evaluated. Patients were studied prospectively over a period of 3 years. Parameters studied included patient demographics, type of dislocation, management, and any complications. Results?Mean age of patients was 6.8 years (range: 3?12 years). Seven patients underwent closed reduction and three patients were managed by open reduction. Of the total 10 patients, excellent results were obtained in 9 patients. One of the patients who reported on the fourth day of trauma and was managed by open reduction had mild joint stiffness with a range of motion of 10 to 40 degrees at final follow-up. None of these patients had infection or instability. Conclusion?After thorough clinical and radiological examination, closed reduction can be done in incomplete and simple complete dislocations of metacarpophalangeal joint of the thumb. Repeated closed reduction should be avoided in complex complete injuries. Early mobilization is advised to prevent joint stiffness.

Blunt trauma to the chest is a very common occurrence in setting of traumatic incidents occurring with highest frequency in young adults between 15-35 years of age. Traumatic chest injuries lead to significant burden of mortality and morbidity in the young population. The most common modes of injury in such patients is motor vehicle accidents followed by other high energy traumatic scenarios like falls from height, contact sports, violence etc. This study was aimed at the evaluation and management of BCT with rib fractures and associated injuries. Material and Methods: The present study was a retrospective cum prospective hospital based study done in SKIMS Medical College Hospital, Srinagar, J & K, India. Sixty four patients who attended the Emergency Department with history of blunt chest injury were included in the study. Patients of all genders between 18 and 65 years of age were included in the study. The data regarding age, gender, mode of injury, presence of thoracic injuries, abdominal injuries, skeletal injuries was gathered and tabulated. Results: We observed a strong male preponderance with 45 out of 64 patients being male. Most common mode of injury was traffic accidents followed by falls from height, fall of heavy objects, hit by animals, violence and contact sports. Associated injuries were seen in both thoracic and extra-thoracic organs. Musculoskeletal injuries were also commonly seen. Patients were managed according to ATLS protocol; fifteen patients were managed with intercostal tube drainage four of which required thoracotomy, four patients required laparotomy for visceral injuries, four patients required fixation of vertebral fractures and musculoskeletal injuries were managed according to the orthopaedic protocols. In the present study four (6.25%) died as a result of massive thoracic injuries. Conclusion: Blunt chest injury is a serious injury which can result in life threatening complications which need to be anticipated, identified and adequately managed to reduce the rates of poor outcome. Integrated management employing the general surgeon, anesthetist, orthopaedician, internist and relevant paramedics is essential. Strict adherence to ATLS protocol is imperative. Adequate fluid resuscitation, ventilatory support, O 2 inhalation, pulmonary physical therapy and efficient analgesia can lead to quick recovery and reduced rates of surgical intervention.

Introduction: Bone defect is a major challenge for reconstruction. The purpose of this case report is to present a case with extensive bone defects of multiple metatarsals of the foot treated using the induced membrane technique.