Background: The purpose of this study was to provide a comprehensive assessment of the impact of the COVID-19 pandemic on the epidemiology of primary and revision arthroplasties of the hip and knee joint. Methods: This study compared the data on knee and hip arthroplasty procedures from 2 hospitals (primary and revision) conducted in two periods: the period of the COVID-19 pandemic in Poland (from 4 March 2020 to 15 October 2020) and the corresponding period prior to the pandemic (from 4 March 2019 to 15 October 2019). We compared the epidemiological data, demographic data, and hospital stay duration data from these two periods. Results: Our analysis demonstrated that the total number of hip arthroplasties conducted in 2020 decreased by 26% in comparison with 2019. In the case of knee arthroplasties, the total number of procedures in the evaluated period in 2020 decreased by 44%. Our study also showed that the mean time of hospital stay for orthopedic patients following hip or knee arthroplasty was 22.87% shorter. The female-to-male patient ratio decreased between the analyzed periods, and this was 22.96% lower during the pandemic. Conclusion: The COVID-19 pandemic in these two hospitals in Poland led to reduced numbers of hip and knee replacement procedures, shorter hospital stays, and a decreased female-to-male patient ratio. The mean age of patients undergoing hip or knee arthroplasty remained unchanged during the national lockdown with respect to the pre-pandemic figure.
Background. The optimal duration of cast immobilization following distal radius fractures (DRFs) in elderly patients has not been established. Objectives.To assess the functional and radiological parameters following DRF treatment in elderly patients using 2 different periods of cast immobilization. Materials and methods.We assessed 50 patients (33 women and 17 men). The mean age at the beginning of treatment was 71 years. The mean duration of follow-up was 1 year and 3 months. One subgroup (n = 26) included patients treated with a cast for 4 weeks, whereas the other subgroup (n = 24) included patients treated with a cast for 6 weeks. The following measures were assessed: union rate, radial inclination, volar tilt, radial height, Visual Analogue Scale (VAS) pain score, Mayo Wrist Score, and VAS activity score.Results. The mean volar tilt was 9. 13° in the group treated with a cast for 4 weeks and 3.29° in the group treated with a cast for 6 weeks (p = 0.043). There were no differences between the groups in terms of any other functional or radiological parameters. Conclusions.The VAS pain score, Mayo Wrist Score and VAS activity score were similar between the 2 study groups. The greatest volar tilt angle was observed after 6 weeks of cast immobilization. The study groups showed no significant differences in terms of radial inclination, union rate, radial height, or bone union. A period of 4 weeks of cast treatment was sufficient for elderly patients with DRFs.
Background: Distal radius fractures pose a serious problem due to their high incidence and can be treated with various methods. No specific distal radius fracture treatment is acknowledged to be the gold standard by orthopedic surgeons. The aim of study was to conduct a comprehensive radiographic assessment of treatment outcomes in patients with distal radius fractures following various types of stabilization in elderly patients. Methods: We retrospectively assessed 122patients who underwent treatment for distal radial fracture in the years 2017and2018.There were three study groups: closed reduction with K-wire fixation (37patients),open reduction with volar plate fixation (42 patients),and closed reduction with cast immobilization (43patients).The mean age at the beginning of treatment was 73years.The mean follow-up period was 2 years and 7months.The following radiological parameters were evaluated: union rate, time to union, time of fracture immobilization, fracture stabilization failure, and the development of adjacent-joint arthritis. Results: There were no significant differences between the study groups in terms of union rate, time to union, and the development of adjacent-joint arthritis. After treatment, the lowest rates of posttraumatic intercarpal and carpometacarpal arthritis and the lowest rates of fracture stabilization failure in our study were observed in the plaster-cast group. Volar plate fixation was associated with the shortest duration of fracture stabilization. In comparison to the status from before treatment, all study groups showed increased rates of intercarpal and carpometacarpal arthritis after treatment. Conclusions: Our radiographic assessments demonstrated similar outcomes, regardless of the stabilization method. In treating distal radius fractures, we achieved good radiographic treatment outcomes irrespective of the fracture stabilization method used.
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