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.
Background There is an increasing trend for most surgeons to choose open reduction and internal fixation of simultaneous distal radius and scaphoid fractures; however, it is not clear if there is any evidence to support this. Case Description The purpose of this systematic review was to investigate the evidence for management of simultaneous distal radius and scaphoid fractures. Literature Review We performed searches of the EMBASE and MEDLINE databases (CRD42020167403). We included a total of 20 studies, involving 178 patients with 182 simultaneous fractures of the distal radius and scaphoid. The distal radius fractures were mostly intra-articular (112/182). The scaphoid fractures were mostly undisplaced (120/148) and at the scaphoid waist (152/178). All distal radius fractures went on to unite, and just 2 of 182 scaphoid fractures went on to nonunion. All included studies were retrospective case series, and therefore all were found to have a critical risk of bias due to confounding. The union rate for both the distal radius and scaphoid fractures is high with both operative and nonoperative treatments. Clinical Relevance Although there are no comparative studies to evaluate the most effective treatment, there is evidence to support operative management. Level of Evidence This is a Level IV, systematic review study.
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Objectives. Sarcopenia is an important preliminary factor for frailty syndrome. The aim of the study was to evaluate the association between nutrition and other potential risk factors and sarcopenia in post-menopausal women. Materials and Methods. A total of 352 post-menopausal patients consecutively admitted to "Ana Aslan" National Institute of Gerontology and Geriatrics have been evaluated. Patients with diseases that could interfere with their nutritional status have been excluded. Following parameters have been considered: age, age of menopause onset, time elapsed since menopause onset, level of school education, average income, area of residence, living arrangements nutritional status and mood disorders. Measuring gait speed on a 6-m course assessed the risk of physical disability and sarcopenia. Results. A significant negative correlation (r=-0.89; p <0.05) was noticed between muscle performance and chronological age. Sarcopenia was not correlated with age of menopause onset. The risk of malnutrition was significantly associated with the risk of sarcopenia (r=0.73; p<0.05). The level of formal education did not correlate with sarcopenia, but patients having family support had a lower risk of physical disability (p<0.05). There was a significant negative association between the presence of mood disorders and gait speed (r=0.58; p<0.05). Conclusions. In conclusion, factors such as the presence of mood disorders and enhanced risk of malnutrition have a significant influence on the occurrence of sarcopenia in postmenopausal women.
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