COVID-19 pandemic: management of patients affected by SARS-CoV-2 in Rome COVID Hospital 2 Trauma Centre and safety of our surgical team

Mauro, Domenico De; Rovere, Giuseppe; Smimmo, Alessandro; Meschini, Cesare; Mocini, Fabrizio; Maccauro, Giulio; Falez, Francesco; Liuzza, Francesco; Ziranu, Antonio

doi:10.1007/s00264-020-04715-6

Cited by 17 publications

(10 citation statements)

References 12 publications

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“…e COVID-19 pandemic has introduced many challenges to healthcare systems around the world, presenting added changes, pressures, and strains at all levels of the system, including but not limited to doctor-patient relationships and health organization resources [1,2]. e pandemic has, in turn, produced several changes in the patient's behavior and clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Delayed Presentation of Patients with Hip Fractures during the COVID-19 “Stay-at-Home” Order in the Southmost Region of the United States

Serra-Torres

Barreda

Weaver

et al. 2021

Advances in Orthopedics

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To evaluate the effects of COVID-19 and stay-at-home orders in traumatic hip fractures presentation, we conducted a retrospective chart review cohort study from March 13 to June 13 in 2020 compared to 2019 from a single-hospital Trauma Level 2 Center. Males and females, 18 years of age and older presenting with a diagnosis of displaced or nondisplaced, intracapsular, or extracapsular hip fracture, underwent standard of care—comparative analysis of the patient’s characteristics and clinical outcomes. The primary study outcomes included age, sex, ethnicity, and body mass index, the onset of injury, date of arrival, payer, the primary type of injury and comorbidities, mechanism of injury, treatment received, postoperative complications, days in an intensive care unit (ICU), discharge disposition, pre- and postinjury functional status, and COVID-19 test. Age, sex, ethnicity, and body mass index were similar in the patients in 2019 compared to 2020. The patients’ average age was 76 years old, 80% reported Hispanic ethnicity, and 63% of the patients were females. Most injuries (90%) occurred due to falls. On average, patients in 2020 presented 4.8 days after the injury onset as compared to 0.7 days in 2019 ( p < 0.05 ). There was an increase in displaced fractures in 2019 compared to 2020 and an increase in patients’ disposition into rehabilitation facilities compared to skilled nursing facilities. Despite the delay in presentation, length of stay, days in the ICU, or functional outcomes of the patients were not affected. Although the patients showed a delayed presentation after hip fracture, this does not appear to significantly interfere with the short-term or the 6-month mortality outcomes of the patients, suggesting the possibility of guided delayed care during times of national emergency and increased strain in hospital resources.

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Section: Introductionmentioning

confidence: 99%

Delayed Presentation of Patients with Hip Fractures during the COVID-19 “Stay-at-Home” Order in the Southmost Region of the United States

Serra-Torres

Barreda

Weaver

et al. 2021

Advances in Orthopedics

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“…Neither of these approaches allows the surgeon a direct view and proper hip exposure [ 26 ]. In 2001, Ganz and his colleagues developed a different surgical technique [ 10 ], to allow a complete exposure of the hip and femoral head through digastric flip osteotomy of the greater trochanter. Since then, clinical trials evaluated this new approach showing positive results.…”

Section: Discussionmentioning

confidence: 99%

“…Between 2017 and 2019, nine cases of Pipkin fractures came to the Emergency Department at the Trauma Center of our Hospital in Rome. The year 2020 was excluded from the time interval, due to a progressive reduction of the emergency activities not COVID-19-related in our Hospital [ 10 ]. All fractures were caused by high-energy traffic accidents resulting in posterior hip dislocation.…”

Section: Methodsmentioning

confidence: 99%

Gibson approach and surgical hip dislocation according to Ganz in the treatment of femoral head fractures

Mauro

Rovere

Smakaj

et al. 2021

BMC Musculoskelet Disord

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Background The purpose of the study is to evaluate clinical and radiological outcomes in those patients with femoral head fracture, treated with open reduction and internal fixation through Gibson approach and Ganz flip trochanter osteotomy. The treatment of Pipkin fractures is very challenging, especially for small trauma centers, because of the unusual fracture patterns and high-level surgical skills required. Case presentation Between 2017 and 2020, nine cases of Pipkin fractures came to the Emergency Department at the Trauma Center of our Hospital in Rome. Inclusion criteria were the diagnosis of femoral head fracture, the open reduction and internal fixation as surgical choice and at least 24 months follow-up. Patients older than 65 years and those treated through total hip replacement or combined hip procedure (CHP) were excluded. Thus, five patients were included in our case series. The clinical outcome was evaluated according to Western Ontario and McMaster Universities Arthritis Index, Vail Hip score, modified Harris Hip score and Merle D’Aubignè Postel score. Radiographic assessment was scored according to Epstein-Thompson classification and heterotopic ossification was assessed through Brooker classification. The mean follow-up was 24 months (range 12-24). Average modified Harris Hip score was 92.1 points (range 75.9–100), and the average Vail score was 81.8 (range 55-95). WOMAC score was assessed in three different subscales, pain (A), stiffness (B) and physical condition (C), with the following results: 1.4 A (range 0-7), 1.2 B (range 0-6) and 6.4 C (range 0-22). Merle d’Aubignè Postel score resulted excellent for four patients and good for one patient. According to Epstein-Thompson score of the radiological outcome, four patients showed a good result and one a fair result. No mechanical or infective complications occurred in the five patients. Conclusions Gibson’s approach and surgical hip dislocation through Ganz trochanteric flip osteotomy allow a good exposure of the femoral head and acetabulum, giving us the possibility to perform an anatomical reduction of the fracture. In our case series, satisfactory clinical and radiological short-term results were obtained without significant complications.

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“…Some papers describe the virus crisis in the local conditions, those papers bring similar data, showing that the work load changed and because of the restrictions in society the cases of trauma or degenerative conditions decreased. Countries that were in the first line to face pandemic published valuable epidemiologic data [19,20,21,22,23] Face-to-face meetings were postponed for months and maybe more. The industry faced a strong diminution of implant use and postponed indefinitely the participation to scientific events, meetings and congresses.…”

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confidence: 99%

mentioning

confidence: 99%

Orthopaedic Surgery during COVID pandemic and consequent Changes in our professional environment

Scarlat

Mavrogenis

2020

International Orthopaedics (SICOT)

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The medical profession was thrilled and faced in first line the changes of the society during the coronavirus crisis and pandemic. [1,2,3,4,5,6] The world experienced stupor and slowdown of major economic activities. Political and social regulations were imposed. All medical specialties had to adapt and observations from our corresponding members and authors worldwide pointed out the changes in our ways of managing different medical conditions including emergency, trauma, transplantation [7] and tumor [8], cases that could not wait. The lockdown and changes in the workflow of medical centers created new challenges for the teams in all specialties, mainly in centers responsible for trauma or tumor and that were supposed to manage patients with unknown infection status. Anesthesiologists were at risk as they were supposed to act on the upper respiratory ways, intubate and ventilate cases with unknown viral charges. This resulted in casualties and morbidity by viral infection in several colleagues and some colleagues sadly and tragically lost their lives. The medical profession paid a high tribute to the pandemic with lethal cases and major stress exposure for the colleagues in the teams. [9,10,11] A special issue was released in August 2020 and included scientific reports from colleagues working in pandemic conditions [12]. All papers showed that the activity decreased, by one side because of the lockdown that kept industry and car traffic at the lowest rhythm but also because hospital regulations that imposed work shortages and security issues. Scheduled procedures were postponed but also "not life threatening trauma" resulting in unfair access

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COVID-19 pandemic: management of patients affected by SARS-CoV-2 in Rome COVID Hospital 2 Trauma Centre and safety of our surgical team

Cited by 17 publications

References 12 publications

Delayed Presentation of Patients with Hip Fractures during the COVID-19 “Stay-at-Home” Order in the Southmost Region of the United States

Delayed Presentation of Patients with Hip Fractures during the COVID-19 “Stay-at-Home” Order in the Southmost Region of the United States

Gibson approach and surgical hip dislocation according to Ganz in the treatment of femoral head fractures

Orthopaedic Surgery during COVID pandemic and consequent Changes in our professional environment

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