Regarding “The orthopaedic and traumatology scenario during Covid-19 outbreak in Italy: chronicles of a silent war” a Mexican perspective
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Cited by 3 publications
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Background/Aim: The Coronavirus disease 2019 has led to significant disruptions in various medical specialties. We herein aimed to provide a systematic review of the published literature on the impact by the pandemic on orthopaedic and traumatological care by focusing on the number of clinical visits, surgeries and reasons for consultation. Materials and Methods: The published literature was reviewed using PubMed. Of 349 studies published between December 1, 2019 and October 1, 2020, 36 original articles met the inclusion criteria. Articles were selected on the basis of the PRISMA guidelines. October 1, 2020 was used as the concluding date of publication. Results: The number of elective visits declined by 50.0% to 74.0%. The number of emergency and trauma visits showed a decrease of 37.7% to 74.2%. Trauma surgery decreased by 21.2% to 66.7% and elective surgeries by 33.3% to 100%. Conclusion: Orthopaedic and trauma surgery is clearly influenced by the pandemic. It will be important to maintain treatment and surgical care of patients in order to avoid negative effects on treatment progress. Since the first cases of a novel respiratory disease occurred in Wuhan, China in December 2019, Coronavirus disease 2019 (Covid-19) has spread worldwide (1). While the World Health Organization (WHO) classified Covid-19 as a public health emergency on January 30, 2020, it changed the classification on March 11, 2020 and rated Covid-19 as a pandemic (2). Since November 29, 2020, 61,866,635 people have been infected with the novel coronavirus. In addition, 1,448,990 infected people have died (3).The Covid-19 pandemic and associated lockdowns have changed our daily lives dramatically, not only by exerting a major impact on our activities and the economy, but especially on our healthcare systems. The large number of infected persons in certain parts of the world has caused hospitals to restructure their departments in order to increase treatment capacity for Covid-19 patients. Angelico et al. reported a 25% decrease in organ transplantations in response to available intensive care unit capacity in the first four weeks in Italy, which was one of the first European countries to deal with the Covid-19 pandemic (4). Furthermore, fewer cases of colorectal carcinoma were diagnosed in Spain during the state of emergency compared to the previous year, probably due to a restriction in endoscopic and surgical procedures and a reduced number of cancer prevention screenings (5). In addition to these medical disciplines, the Covid-19 pandemic also affected orthopaedics and traumatology, where elective surgeries were postponed and nonurgent consultations cancelled to minimize the risk of infection for patients and medical staff (6,7).The aim of this systematic literature review was to provide an overview of the impact of the Covid-19 pandemic on orthopaedic and traumatologic care by comparing previously published reports from different countries, especially focusing on the number of clinical visits, surgeries and reasons for consultation. Mate...
Background/Aim: The Coronavirus disease 2019 has led to significant disruptions in various medical specialties. We herein aimed to provide a systematic review of the published literature on the impact by the pandemic on orthopaedic and traumatological care by focusing on the number of clinical visits, surgeries and reasons for consultation. Materials and Methods: The published literature was reviewed using PubMed. Of 349 studies published between December 1, 2019 and October 1, 2020, 36 original articles met the inclusion criteria. Articles were selected on the basis of the PRISMA guidelines. October 1, 2020 was used as the concluding date of publication. Results: The number of elective visits declined by 50.0% to 74.0%. The number of emergency and trauma visits showed a decrease of 37.7% to 74.2%. Trauma surgery decreased by 21.2% to 66.7% and elective surgeries by 33.3% to 100%. Conclusion: Orthopaedic and trauma surgery is clearly influenced by the pandemic. It will be important to maintain treatment and surgical care of patients in order to avoid negative effects on treatment progress. Since the first cases of a novel respiratory disease occurred in Wuhan, China in December 2019, Coronavirus disease 2019 (Covid-19) has spread worldwide (1). While the World Health Organization (WHO) classified Covid-19 as a public health emergency on January 30, 2020, it changed the classification on March 11, 2020 and rated Covid-19 as a pandemic (2). Since November 29, 2020, 61,866,635 people have been infected with the novel coronavirus. In addition, 1,448,990 infected people have died (3).The Covid-19 pandemic and associated lockdowns have changed our daily lives dramatically, not only by exerting a major impact on our activities and the economy, but especially on our healthcare systems. The large number of infected persons in certain parts of the world has caused hospitals to restructure their departments in order to increase treatment capacity for Covid-19 patients. Angelico et al. reported a 25% decrease in organ transplantations in response to available intensive care unit capacity in the first four weeks in Italy, which was one of the first European countries to deal with the Covid-19 pandemic (4). Furthermore, fewer cases of colorectal carcinoma were diagnosed in Spain during the state of emergency compared to the previous year, probably due to a restriction in endoscopic and surgical procedures and a reduced number of cancer prevention screenings (5). In addition to these medical disciplines, the Covid-19 pandemic also affected orthopaedics and traumatology, where elective surgeries were postponed and nonurgent consultations cancelled to minimize the risk of infection for patients and medical staff (6,7).The aim of this systematic literature review was to provide an overview of the impact of the Covid-19 pandemic on orthopaedic and traumatologic care by comparing previously published reports from different countries, especially focusing on the number of clinical visits, surgeries and reasons for consultation. Mate...
Particularities of upper extremity fractures in patients with COVID-19
Background. Treatment of the fractures in patients with COVID-19, given the novelty of this problem, is one of the most difficult tasks of modern traumatology and orthopedics. The purpose of this study was to determine the peculiarities of the course of the traumatic process in victims with fractures of the upper limbs against the background of COVID-19. Materials and methods. To carry out our research, we retrospectively analyzed the treatment of 136 trauma patients who underwent inpatient treatment in one of the city hospitals of Kyiv from 2019 to 2021. In our study, we used the generally accepted AO/ASIF classification of fractures to determine the clinical and nosological characteristics of injuries in patients with COVID-19. Results. During the COVID-19 epidemic, fractures to the distal part of the forearm (28.8 %), clavicle (17.8%) and proximal part of the shoulder (15.1 %) were most often detected. Among segmental injuries in patients with COVID-19, forearm (in 42.5 % of cases) and shoulder (in 35.6 % of cases) fractures predominated. Also, simple fractures of type A (72.6 %) were more common, and much less fragmentary fractures of type B (21.9 %) and multifragmentary type C fractures (5.5 %) were present. It is worth noting a significant decrease in the number of hand injuries during the COVID-19 pandemic by almost 7 times. In our opinion, this is due to the lockdown introduced by the authorities of Ukraine, which significantly reduced the number of industrial injuries among the research sample. Conclusions. We concluded that the COVID-19 pandemic significantly affected the clinical and nosological structure and characteristics of bone fractures of the upper limb girdle, the analysis of cases proved that such changes in the clinical and nosological structure of fractures of the upper limb girdle are associated with changes in life activities during the pandemic and more typical for domestic trauma.
Background: Lockdown imposed to limit the spread of COVID 19 may have had a significant effect on the time to care, demography, injury causation, injury characteristics, volume and nature of admission, management and outcome of paediatric orthopaedic trauma patients. Objective: To document the effect of lockdown on the time to care at KGMU, use of ambulance, volume and type of admissions, demography, injury causation, injury characteristics, management and outcome of paediatric orthopaedic trauma patients. Methods:. This record review compared age, sex, type of admission, mechanism of injury, injury characteristics, type of treatment, vehicle used for transport, and outcome among patients admitted in pre-lockdown, lockdown and post lockdown. Results: Lockdown was associated with decrease in the number of cases (p<0.01), increase in the time since injury to reception (p<0.040), a rise in the share of referred admission (p<0.040), time since reception at KGMU, time to definitive care (p<0.001), high energy falls (p<0.001), injuries at home (p<0.001), higher ISS (p<0.001), non operative treatment (p=0.038) and greater use of ambulance (p=0.003). Conclusion: Lockdown resulted in a significant change in the causation and management of injury, significant delays in timeliness of care, reduction in the volume of admissions, an increase in injury severity and share of referral admissions.
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