Strategies in reconfiguration of hand injuries management during COVID-19 pandemic

Venkatesan, Aakaash Sethuraman; Iyengar, Karthikeyan P; Loh, William Y. C.

doi:10.1016/j.jcot.2020.05.020

Cited by 9 publications

(14 citation statements)

References 4 publications

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“… 9 Several UK centres have subsequently published correspondence or short reports describing similar reorganization of services to those we used. 10 - 12 See-and-treat principles, increased local anaesthetic and WALANT technique use, strategies to reduce follow-up visits, such as self removal of dressings and dissolvable sutures, along with virtual follow-up, have been widely used to provide safe and effective care for patients and staff during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

The effect of the COVID-19 lockdown on hand trauma surgery utilization

Atia¹,

Pocnetz²,

Selby³

et al. 2020

Bone & Joint Open

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Aims The aim of this study was to evaluate the need for hand trauma services during the COVID-19 pandemic lockdown, specifically related to surgical requirements. This will provide useful information for planning and resource allocation in the event of any further lockdown. Methods A prospective analsysis of all patients attending our hand trauma unit throughout the UK COVID-19 lockdown period (24 March to 10 May 2020) was carried out. Prospectively collected departmental data from the same period in 2019 was obtained and reviewed for comparison. The number of patients attending clinic, undergoing surgery, the type of surgical procedure, and rate of surgery was compared. Results In all, 463 patients attended hand trauma services during the lockdown period compared to 793 in 2019 (32% reduction); 190 surgical procedures were carried out during lockdown compared to 236 in 2019 (20% reduction). Intervention rate was higher during the lockdown period (41% compared to 30%). There was no difference in the type of cases. In the first half of lockdown, 47% fewer procedures were performed than in 2019, but in the second half of lockdown 13% more procedures were carried out than the same period in 2019. Conclusion Requirements for hand trauma surgery remain high during a pandemic lockdown. Attendances and surgical requirements can be expected to steadily return to normal levels during a prolonged lockdown period. Throughout any future lockdown period adequate surgical provision must be maintained for patients with hand injuries.

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Section: Discussionmentioning

confidence: 99%

The effect of the COVID-19 lockdown on hand trauma surgery utilization

Atia¹,

Pocnetz²,

Selby³

et al. 2020

Bone & Joint Open

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“…This allowed manipulation of fractures and the ability to check the position in a plaster radiologically without the patient leaving the clinic. 21 This group also implemented a National Health Service (NHS) digital technology initiative, which allowed video consultations with patients. Video consultations could provide us with an improved strategy to telephone consultations and both this and C-arm use in clinic could reduce face-to-face attendances even further.…”

Section: Changes To Staff Working Patternsmentioning

confidence: 99%

Service reconfiguration in the department of hand surgery during the UK COVID-19 lockdown: Birmingham experience

Picardo

Walker

Vanat

et al. 2021

Postgraduate Medical Journal

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In early 2020, the COVID-19 pandemic swept through the UK and had a major impact on healthcare services. The Birmingham hand centre, one of the largest hand trauma units in the country, underwent a dramatic service reconfiguration to enable robust and safe provision of care that would withstand the peak of the pandemic. Streamlining our service significantly reduced patient footfall and hospital admission while preventing intra-hospital viral transmission. Many of the changes implemented have been kept as permanent adjustments to our practice as this new model of care yields higher patient satisfaction and efficacy to withstand the pressures of further peaks in the pandemic.

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“…2 Like in other traumatological fields, the management of major hand and wrist trauma, which usually requires hospitalization and surgical treatment, was made even more challenging by this national emergency. 7 How can movement restrictions, the effects of quarantine itself and the changes in health policies influence the type and incidence of hand and wrist trauma? No data have been published yet to describe the variation in the incidence of upper limb trauma during COVID-19 epidemic.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

How hand and wrist trauma has changed during covid-19 emergency in Italy: Incidence and distribution of acute injuries. What to learn?

Poggetti

Chiaro

Nucci

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Background: the purpose is to gather and analyze the statistical datas of wrist and hand injuries admitted to the Hand and Reconstructive Microsurgery and Replantation Hub center of Careggi Hospital, Florence during the first two months of COVID-19 epidemic in Italy. The Authors investigated how the drastic changes in daily activities modified the epidemiology of hand trauma lesions. Methods: The Authors analyzed the characteristics of hand and wrist traumatic disorders during the months of February and March comparing 2019 to 2020. Collected data included age distribution, traumatic etiology, diagnosis and type of surgical procedures. Results: The total number of orthopedic and trauma patients significantly decrease in 2020 compared to 2019 (3360 vs 1470). The number of hand and wrist injuries didn't show a significant difference between 2019 and 2020 instead (192 vs 131). The overall number of patients hospitalized and surgically treated at our Operative Unit (OU) was 168 in 2019 and 120 in 2020. Male patients resulted prevalent (60,7 M vs 39,3F/2019; 63,2 M vs 36,8F/2020). In terms of patient age, in 2020 we registered a significant reduction of cases in the 20-35-year-old age group and a significant increase in the 51e65 and 66-80-year-old age groups. Traffic-related, sport-related and fortuitous injuries significantly decreased in 2020, while the number of domestic accidents significantly increased. Analyzing the Hospital Discharge Records (HDR), we found a significant increase in the number of proximal and middle phalanx fractures; no significant differences were found for other kinds of discharge diagnosis. As for the choice of surgical treatment options, no differences were found between 2019 and 2020. Conclusion: Even during drastic movement restrictions and the prolonged suspension of work and leisure activities secondary to COVID-19 epidemic in 2020, hand and wrist traumas rate remained almost the same compared to the same period of the previous year. Nevertheless, a significant change in the etiology and patient age was registered. In fact, sport and traffic-related traumas decreased respect to domestic traumas, while the previous prevalent involvement of young adults was surpassed by accidental hand traumas in the elderly and active adults.

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Strategies in reconfiguration of hand injuries management during COVID-19 pandemic

Cited by 9 publications

References 4 publications

The effect of the COVID-19 lockdown on hand trauma surgery utilization

The effect of the COVID-19 lockdown on hand trauma surgery utilization

Service reconfiguration in the department of hand surgery during the UK COVID-19 lockdown: Birmingham experience

How hand and wrist trauma has changed during covid-19 emergency in Italy: Incidence and distribution of acute injuries. What to learn?

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