The patterns and management of fracture patients under COVID-19 outbreak in China

Abstract

Background: Currently, the perioperative care of fracture patients is compromised due to the outbreak of COVID-19 in China and the world. This study aims to assess the clinical features of fracture patients at our hospital during the COVID-19 outbreak and formulate the medical steps to ensure the effective treatment of fracture patients with minimal risk of infection to healthcare workers.Methods: One hundred twelve patients with different fractures that were admitted to the orthopedics department of our hospital from January 24 to March 9 in 2020 were reviewed. Data including age, gender, injury location, admission time, operation time, discharge time were compared with fracture patients from the same period in 2019Results: Compared to the same period in 2019, there is a 42% decrease in the number of fracture patients in 2020. Specifically, the incidences of forearm, thigh, hand, and foot fractures have increased during the COVID-19 outbreak, while other parts are less affected. The time from injury to hospitalization, the surgery wait time and time of discharge after surgery for patients with hip fractures were 2.9±7.1, 2.0±1.7 and 7.7± 4.0 days respectively in 2019, which changed to 2.0±5.0, 4.5±4.0 and 10.6±4.2 days in 2020. Following the orthopedic treatment regimen followed at our hospital, all patients had non-life-threatening limb fractures.Six patients were operated in a negative pressure room, and emergency screening was completed for six patients. No patients were positive for COVID-19, and all were discharged safely without infection or other serious complications.Conclusions: Hip fractures are highly prevalent during this epidemic. However, mandatory screening delays surgery by more than 48 hours. The orthopedic department should prioritize screening of emergency patients to minimize the risk of infection among other patients and medical personnel.

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The Epidemiology of Hip and Knee Primary and Revision Arthroplasties during the COVID-19 Pandemic

“…The COVID-19 pandemic has considerably altered the way the entire healthcare systems operate, including the way orthopedic wards function [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Doctors and nurses from orthopedic wards found themselves in a completely new situation.…”

“…The COVID-19 pandemic resulted in global changes in the functioning of healthcare facilities in 2020 [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. The pandemic substantially limited public access to medical specialists; it also affected workflow routines and patient admission criteria in orthopedic wards [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. Some healthcare professionals contracted SARS-CoV-2 and, consequently, had to undergo quarantine, while others were delegated to the care of COVID-19 patients, which affected the number of patients hospitalized at orthopedic wards [ 2 , 3 ].…”

Effects of the COVID-19 Pandemic on the Epidemiology of Knee and Shoulder Arthroscopy Procedures in a University Hospital Department in Poland

“…Due to the pandemic, patients have encountered considerable limitations in their access to healthcare professionals, including orthopedic surgeons. The character of work in orthopedic wards and the orthopedic admission protocols have also changed [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Some healthcare workers contracted COVID-19 and were obligated to undergo quarantine; some were transferred to take care of COVID-19positive patients.…”