Global experience of orthopaedic trauma surgeons facing COVID-19: a survey highlighting the global orthopaedic response

Abstract

Background The COVID-19 (SARS-CoV-2) pandemic has significantly affected all aspects of healthcare, including orthopaedics. Due to the unique challenges presented by COVID-19 as well as the distinct timeframes that it will surge in different geographies, much can be learned from the experiences of orthopaedic professionals in many global settings. The goal of this project is to characterize the preparations, strategies, lessons, and personal experiences of orthopaedic trauma surgeons and departments across the world in combating COVID-19. In doing so, we will shed light on current practices and challenges, which may help us manage the current pandemic in addition to preparing for future global pandemics that may arise. Methods A 20-item questionnaire was sent out to 150 orthopaedic trauma surgeons representing 42 countries who were identified based on professional relationships and/or prior involvement in international meetings either led or participated by the senior author. Results The questionnaire was completed by 63 orthopaedic trauma surgeons representing 28 countries and 14 US states. The results of this study show that orthopaedic trauma departments across the world have been greatly impacted by COVID-19 with 91% of participating hospitals currently having a reduced case load compared with pre-COVID-19 and only 17% of respondents currently performing elective orthopaedic surgery. Furthermore, 30% of orthopaedic departments have deployed orthopaedic personnel to non-orthopaedic floors in order to help mitigate the increased patient load and 86% of respondents noted at least some shortage of PPE. Lastly 73% of participating orthopedic departments including those in LMICs, have incorporated telemedicine into their practice with a majority stating that it would most likely become a permanent change to their practice post-COVID-19. Conclusion To our knowledge, this is the largest data set characterizing global COVID-19 situations and responses of orthopaedic trauma practices around the world. There is much to be learned from each of the participants' responses in order to persevere during the current pandemic, as well as to prepare for future pandemics as it relates specifically to orthopaedic trauma practices.

Changing Pattern of Orthopaedic Trauma Admissions During COVID-19 Pandemic: Experience at a Tertiary Trauma Centre in India

“…A survey of international surgeons [5] revealed significant changes in trauma management and orthopaedic practice worldwide; 63 orthopaedic centres from 28 countries informed that 91% centres had a reduced workload and only 17% of these were doing elective surgeries. 30% of these had needed to deploy orthopaedic personnel to help in non-orthopaedic areas prior to May 15, 2020.…”

Post-COVID-19 return to elective orthopaedic surgery—is rescheduling just a reboot process? Which timing for tests? Is chest CT scan still useful? Safety of the first hundred elective cases? How to explain the “new normality health organization” to patients?

“…We have implemented an updated informed consent process that includes an explicit discussion about the steps the institution has taken to mitigate the risk of contracting COIVD-19 during the elective surgery, including preoperative testing, daily screening of staff and use of appropriate PPE. Patients should also be informed about visitor restrictions [12][13][14]. Our institution as many others [15][16][17] has made adjustments: a "no visitor" policy which extends to elective surgery.…”

Global orthopaedic trauma surgeons highlight telenomics during the COVID-19 era: A case for advancing telemedicine in orthopaedics

“…Our team has summarized some of the existing literature on telemedicine in orthopaedics and linked it to the results of our Global Orthopaedic Trauma Survey describing the effects of COVID-19 on global practices. 2 We seek to provide more information to orthopaedic leaders and change agents who, as professionals representing their specialty, may help redefine policies and care models that serve the best interests of payers, providers, and patients.…”