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Regas I, Pichonnat M, Pluvy I, Obert L, Bellemère P, Chaves C, Loisel F. [The impact of COVID-19 on hand surgery: A French retrospective comparative study in COVID-19 and non-COVID-19 hand trauma centers]. REVUE DE CHIRURGIE ORTHOPEDIQUE ET TRAUMATOLOGIQUE 2023; 109:41-47. [PMID: 34667485 PMCID: PMC8516796 DOI: 10.1016/j.rcot.2021.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/20/2021] [Indexed: 02/08/2023]
Abstract
Introduction En 2020, la pandémie a divisé la France en zone COVID-19 et non COVID-19. L’objectif principal de notre étude était de comparer la variabilité de l’activité chirurgicale et de consultation de 2 centres SOS main entre la période de pandémie et hors pandémie. Les objectifs secondaires étaient d’identifier les patients à risque afin de développer des moyens de prévention en traumatologie de la main. Méthodes Il s’agit d’une étude rétrospective bi-centrique à visée épidémiologique sur les admissions aux urgences traumatologiques pendant le premier confinement français. Les données ont été comparées à la même période en 2019 (groupe contrôle). 2055 patients ont consulté pour un traumatisme de la main ou du poignet. Résultats En 2020, l’activité des centres SOS main a diminué de 35 % en zone COVID-19 contre 24 % en zone non COVID-19 par rapport à la même période en 2019 (p < 0,0001 IC95 6,5–15,6). En comparant 2019 et 2020, l’incidence des plaies a augmenté en zone COVID-19 (58 % vs 78 % p < 0,0001) et diminué en zone non COVID-19 (55 % vs 50 % p < 0,0001). Les plaies complexes (16 % vs 35 % p < 0,0001 et 15 % vs 17 % p < 0,0001) et les fractures ouvertes (8 % vs 14 % p 0,019 et 4,5 % vs 5,3 % p < 0,0001) ont augmenté dans les 2 zones pendant la pandémie. Le taux d’hommes travailleurs non manuels blessés lors d’accidents de la vie courante (76 % vs 36 % p < 0,0001) est majoré toute zone confondue. Conclusion Les traumatismes de la main et du poignet sont moins fréquents mais plus graves pendant la pandémie comparativement à la même période en 2019. En encourageant la population à être consciente des risques et des moyens pour les éviter, comme une meilleure information et le respect de consignes de sécurité, nous pourrions minimiser ces risques. Ces données peuvent être utiles à la planification de stratégies de prévention pour de futurs confinements. Niveau de preuve III ; étude cas contrôle.
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Affiliation(s)
- Inès Regas
- Service d’orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3 boulevard Alexandre Fleming, 25030 Besançon, France,Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise Paré, 25030 Besançon, France,Nanomédecine, imagerie, thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise Paré, 25030 Besançon, France,Auteur correspondant
| | - Marine Pichonnat
- Service d’orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3 boulevard Alexandre Fleming, 25030 Besançon, France,Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise Paré, 25030 Besançon, France,Nanomédecine, imagerie, thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise Paré, 25030 Besançon, France
| | - Isabelle Pluvy
- Service d’orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3 boulevard Alexandre Fleming, 25030 Besançon, France,Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise Paré, 25030 Besançon, France,Nanomédecine, imagerie, thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise Paré, 25030 Besançon, France
| | - Laurent Obert
- Service d’orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3 boulevard Alexandre Fleming, 25030 Besançon, France,Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise Paré, 25030 Besançon, France,Nanomédecine, imagerie, thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise Paré, 25030 Besançon, France
| | - Philippe Bellemère
- Institut de la Main Nantes Atlantique, boulevard Charles-Gautier, 44800 Saint Herblain, France
| | - Camilo Chaves
- Institut de la Main Nantes Atlantique, boulevard Charles-Gautier, 44800 Saint Herblain, France
| | - François Loisel
- Service d’orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3 boulevard Alexandre Fleming, 25030 Besançon, France,Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise Paré, 25030 Besançon, France,Nanomédecine, imagerie, thérapeutique-EA 4662, Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise Paré, 25030 Besançon, France
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Regas I, Pichonnat M, Pluvy I, Obert L, Bellemère P, Chaves C, Loisel F. The impact of COVID-19 on hand surgery: A French retrospective comparative study in COVID-19 and non-COVID-19 hand trauma centers. Orthop Traumatol Surg Res 2023; 109:103118. [PMID: 34656810 PMCID: PMC8516143 DOI: 10.1016/j.otsr.2021.103118] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/05/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION In 2020, the pandemic divided France into two zones: COVID-19 and non-COVID-19. The main objective of our study was to compare the variability of surgical and emergency consultation activity amongst two hand trauma centers, between the pandemic period and outside the pandemic period. The secondary objective was to identify at-risk patients in order to develop preventative strategies in hand trauma. METHODS This bi-centric retrospective study considered the epidemiology of admissions to trauma centers during the first French lockdown. The data were compared to the same period in 2019 (control group). Two thousand and fifty-five patients underwent consultations for hand or wrist trauma. RESULTS The first French lockdown was associated with a 35% decrease in hand and wrist injuries in the COVID-19 zone versus 24% in the non-COVID-19 zone, compared to the same period in 2019 (p<0.0001, 95% CI: 6.5-15.6). Comparing 2019 and 2020, the incidence of wounds significantly increased in the COVID-19 zone (58% vs. 78%, p<0.0001) and significantly decreased in the non-COVID-19 zone (55% vs. 50%, p<0.0001). Complex wounds (16% vs. 35%, p<0.0001 and 15% vs. 17%, p<0.0001) and open fractures (8% vs. 14%, p=0.019 and 4.5% vs. 5.3%, p<0.0001) significantly increased in both zones during the pandemic. The rate of male, non-manual workers injured in domestic accidents (76% vs. 36%, p<0.0001) was significantly increased in all areas. CONCLUSION Hand and wrist trauma was less frequent but more severe during the pandemic compared to the same period in 2019. By encouraging the public to be aware of the risks and the means to avoid trauma, such as better information and compliance with safety instructions, we could minimize these risks. This data can be useful in planning preventative strategies for future lockdowns. LEVEL OF EVIDENCE III; case-control study.
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Affiliation(s)
- Inès Regas
- Service d'orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon, France; Nanomédecine, imagerie, thérapeutique - EA 4662, université de Bourgogne Franche-Comté, sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon, France.
| | - Marine Pichonnat
- Service d'orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon, France; Nanomédecine, imagerie, thérapeutique - EA 4662, université de Bourgogne Franche-Comté, sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon, France
| | - Isabelle Pluvy
- Service d'orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon, France; Nanomédecine, imagerie, thérapeutique - EA 4662, université de Bourgogne Franche-Comté, sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon, France
| | - Laurent Obert
- Service d'orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon, France; Nanomédecine, imagerie, thérapeutique - EA 4662, université de Bourgogne Franche-Comté, sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon, France
| | - Philippe Bellemère
- Institut de la main Nantes Atlantique, boulevard Charles-Gautier, 44800 Saint-Herblain, France
| | - Camilo Chaves
- Institut de la main Nantes Atlantique, boulevard Charles-Gautier, 44800 Saint-Herblain, France
| | - François Loisel
- Service d'orthopédie, de traumatologie, de chirurgie plastique, reconstructrice et assistance main, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon, France; Université de Bourgogne Franche-Comté, Sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon, France; Nanomédecine, imagerie, thérapeutique - EA 4662, université de Bourgogne Franche-Comté, sciences médicales et pharmaceutiques, 19, rue Ambroise-Paré, 25030 Besançon, France
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Shahid S, Saghir N, Saghir R, Young-Sing Q, Miranda BH. WALANT: A Discussion of Indications, Impact, and Educational Requirements. Arch Plast Surg 2022; 49:531-537. [PMID: 35919552 PMCID: PMC9340192 DOI: 10.1055/s-0042-1748659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Wide-awake, local anesthesia, no tourniquet (WALANT) is a technique that removes the requirement for operations to be performed with a tourniquet, general/regional anesthesia, sedation or an anesthetist. We reviewed the WALANT literature with respect to the diverse indications and impact of WALANT to discuss the importance of future surgical curriculum integration. With appropriate patient selection, WALANT may be used effectively in upper and lower limb surgery; it is also a useful option for patients who are unsuitable for general/regional anesthesia. There is a growing body of evidence supporting the use of WALANT in more complex operations in both upper and lower limb surgery. WALANT is a safe, effective, and simple technique associated with equivalent or superior patient pain scores among other numerous clinical and cost benefits. Cost benefits derive from reduced requirements for theater/anesthetic personnel, space, equipment, time, and inpatient stay. The lack of a requirement for general anesthesia reduces aerosol generating procedures, for example, intubation/high-flow oxygen, hence patients and staff also benefit from the reduced potential for infection transmission. WALANT provides a relatively, but not entirely, bloodless surgical field. Training requirements include the surgical indications, volume calculations, infiltration technique, appropriate perioperative patient/team member communication, and specifics of each operation that need to be considered, for example, checking of active tendon glide versus venting of flexor tendon pulleys. WALANT offers significant clinical, economic, and operative safety advantages when compared with general/regional anesthesia. Key challenges include careful patient selection and the comprehensive training of future surgeons to perform the technique safely.
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Affiliation(s)
- Shahab Shahid
- The Centre for Hand Surgery, St. Andrew's Centre for Plastic Surgery & Burns, Broomfield Hospital, Chelmsford, United Kingdom
| | - Noman Saghir
- Nightingale Breast Centre, Wythenshawe Hospital, Manchester, United Kingdom
| | - Reyan Saghir
- Department of Cardiology, Calderdale Royal Hospital, Halifax, United Kingdom
| | - Quillan Young-Sing
- The Centre for Hand Surgery, St. Andrew's Centre for Plastic Surgery & Burns, Broomfield Hospital, Chelmsford, United Kingdom
| | - Benjamin H Miranda
- The Centre for Hand Surgery, St. Andrew's Centre for Plastic Surgery & Burns, Broomfield Hospital, Chelmsford, United Kingdom.,St Andrew&s Anglia Ruskin (StAAR) Research Group, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, United Kingdom
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Lugli G, Ottaviani MM, Botta A, Ascione G, Bruschi A, Cagnazzo F, Zammarchi L, Romagnani P, Portaluri T. The Impact of the SARS-CoV-2 Pandemic on Healthcare Provision in Italy to non-COVID Patients: a Systematic Review. Mediterr J Hematol Infect Dis 2022; 14:e2022012. [PMID: 35070219 PMCID: PMC8746940 DOI: 10.4084/mjhid.2022.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/16/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Italy has been one of the countries most affected by the SARS-CoV-2 pandemic, and the regional healthcare system has had to quickly adapt its organization to meet the needs of infected patients. This has led to a drastic change in the routine management of non-communicable diseases with a potential long-term impact on patient health care. Therefore, we investigated the management of non-COVID-19 patients across all medical specialities in Italy. METHODS A PRISMA guideline-based systematic review of the literature was performed using PubMed, Embase, and Scopus, restricting the search to the main outbreak period in Italy (from February 20 to June 25 2020). We selected articles in English or Italian that detailed changes in the Italian hospital care for non-COVID-19 patients due to the pandemic. Our keywords included all medical specialities combined with our geographical focus (Italy) and COVID-19. RESULTS Of the 4643 potentially eligible studies identified by the search, 247 were included. A decrease in the management of emergencies in non-COVID patients was found together with an increase in mortality. Similarly, non-deferrable conditions met a tendency toward decreased diagnosis. All specialities have been affected by the re-organization of healthcare provision in the hub-and-spoke system and have benefited from telemedicine. CONCLUSIONS Our work highlights the changes in the Italian public healthcare system to tackle the developing health crisis due to the COVID-19 pandemic. The findings of our review may be useful to analyse future directions for the healthcare system in the case of new pandemic scenarios.
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Affiliation(s)
- Gianmarco Lugli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- CEST Centre for Excellence and Transdisciplinary Studies, Turin, Italy
| | - Matteo Maria Ottaviani
- Department of Neurosurgery, University Politecnica delle Marche, Ancona, Italy
- CEST Centre for Excellence and Transdisciplinary Studies, Turin, Italy
| | - Annarita Botta
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- CEST Centre for Excellence and Transdisciplinary Studies, Turin, Italy
| | - Guido Ascione
- Department of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
- CEST Centre for Excellence and Transdisciplinary Studies, Turin, Italy
| | - Alessandro Bruschi
- Rizzoli Orthopaedic Institute, University of Bologna, Bologna, Italy
- CEST Centre for Excellence and Transdisciplinary Studies, Turin, Italy
| | - Federico Cagnazzo
- Department of Neuroradiology, Hôpital Gui de Chauliac, Montpellier University Medical Center, 80, Avenue Augustin Fliche, Montpellier, France
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Infectious and Tropical Disease, University Hospital Careggi, Florence, Italy
| | - Paola Romagnani
- Nephrology and Dialysis Unit, Department of Pediatrics, Meyer Children’s University Hospital, Florence, Italy
- Department of Biomedical Experimental and Clinical Sciences “Mario Serio,” University of Florence, Florence, Italy
| | - Tommaso Portaluri
- IN Srl, Udine, Italy
- CEST Centre for Excellence and Transdisciplinary Studies, Turin, Italy
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Pidgeon TE, Parthiban S, Malone P, Foster M, Chester DL. Injury patterns of patients with upper limb and hand trauma sustained during the COVID-19 pandemic lockdown in the UK: a retrospective cohort study. HAND SURGERY & REHABILITATION 2021; 40:235-240. [PMID: 33713858 PMCID: PMC8501748 DOI: 10.1016/j.hansur.2021.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/20/2021] [Accepted: 03/07/2021] [Indexed: 12/03/2022]
Abstract
This work aimed to identify the lead causes of upper limb injury presenting to a busy hand and major trauma unit during the UK COVID-19 domestic lockdown period, in comparison to a cohort from the same period one year previously. Hand and upper limb injuries presenting to the host organization during a pre-lockdown period (23rd March 2019-11th May 2019) and the formal UK lockdown period (23rd March 2020-11th May 2020) were compared, using data collated from the host institution's hand surgery database. The UK lockdown period was associated with a 52% fall in the number of patients presenting to the service with hand and upper limb injuries (589 pre-lockdown vs. 284 during lockdown). There was a significant increase in the proportion of injuries due to machinery use during lockdown (38, 6.5% pre-lockdown vs. 33, 11.6% during lockdown, P = 0.009), other etiologies were consistent. The proportion requiring surgical management were similar (n = 272, 46.2% pre-lockdown vs. n = 138, 48.6% during lockdown, P = 0.50). The proportion requiring overnight admission fell (n = 94, 16.0% pre-lockdown vs. 29, 10.2% during lockdown, P = 0.022). COVID-19 related lockdown in the UK resulted in a reduction in the presenting numbers of hand related injuries; however almost half of these patients still required surgery. These data may be of use to other hand surgery centers for resource planning during future lockdown periods, and for injury prevention strategies in the post-COVID-19 world.
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Affiliation(s)
- T E Pidgeon
- Birmingham Hand Centre, University Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2TH, United Kingdom.
| | - S Parthiban
- Birmingham Hand Centre, University Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2TH, United Kingdom.
| | - P Malone
- Birmingham Hand Centre, University Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2TH, United Kingdom.
| | - M Foster
- Birmingham Hand Centre, University Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2TH, United Kingdom.
| | - D L Chester
- Birmingham Hand Centre, University Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2TH, United Kingdom.
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Rawal M, Kathayet TS, Rokaya PK, Thakur AK, Mahat S, Acharya BD, Karki DB, Ojha S. Orthopaedics Practice in a Rural Hospital During the COVID-19 Pandemic: A Descriptive Cross-Sectional Study. JNMA J Nepal Med Assoc 2020; 58:847-850. [PMID: 34506407 PMCID: PMC7775012 DOI: 10.31729/jnma.5543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The coronavirus disease 2019 pandemic is one of the biggest public health challenges that we have faced, and has had a significant impact on the delivery of essential healthcare worldwide. Trauma and orthopaedic surgery was one of the most severely affected specialties as all non-emergency surgical cases were cancelled. With the possibility of future peak of corona virus, knowing the impact of Covid on orthopaedics would enable us to manage trauma patient in an effective manner and will help us to resume normal schedule of the trauma care. METHODS This is a descriptive cross-sectional study. We studied the details of total number of patient at Orthopaedic and trauma outpatient, inpatient and operation theatre of Karnali Academy of Health Sciences from 14th March 2020 to 16 September 2020 as compared with the patient data from the same time period in 2019. RESULTS There were 2288 patients during the non-Covid period who visited to the orthopaedic outpatient in comparison to 1618 during Covid period. Only 5 implant removals were performed in comparison to 50 removals (90% reduction) in elective cases. But the number of surgical cases was almost similar (204 vs 207 respectively). Total number of hospital stay had significantly reduced in the non-COVID period (average 4 days vs 6 days).There were 181 in-patient admissions during the COVID period while 241 admission during the non-COVID period. CONCLUSIONS There is reduction in number of orthopaedic and trauma cases during COVID 19 with marked reduction in number of elective cases. Alternative methods of treatment like telemedicine and small scale health camps at peripheral districts should be conducted to treat non-urgent orthopaedic conditions during lockdown.
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Affiliation(s)
- Mangal Rawal
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Tufan Singh Kathayet
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Poojan Kumar Rokaya
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Abhishek Kumar Thakur
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Smritee Mahat
- Department of Pathology, Institute of Medicine, Maharajgunj, Kathmandu, Nepal
| | - Bishnu Dutta Acharya
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Dhan Bahadur Karki
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Sujata Ojha
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
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Atia F, Pocnetz S, Selby A, Russell P, Bainbridge C, Johnson N. The effect of the COVID-19 lockdown on hand trauma surgery utilization. Bone Jt Open 2020; 1:639-643. [PMID: 33215095 PMCID: PMC7659702 DOI: 10.1302/2633-1462.110.bjo-2020-0133.r1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
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.Cite this article: Bone Joint Open 2020;1-10:639-643.
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Régas I, Bellemère P, Lamon B, Bouju Y, Lecoq FA, Chaves C. Hand injuries treated at a hand emergency center during the COVID-19 lockdown. HAND SURGERY & REHABILITATION 2020; 39:459-461. [PMID: 32777488 PMCID: PMC7411507 DOI: 10.1016/j.hansur.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/18/2020] [Accepted: 07/28/2020] [Indexed: 10/26/2022]
Abstract
The recent coronavirus outbreak has tested the adaptability, cooperation and organizational capabilities of our healthcare systems. Restrictions were implemented in several countries to reduce virus transmission whilst emergency departments (ED) were overwhelmed and there was shortage of healthcare providers. Given this situation and the consequences of hand injuries, we studied the epidemiology of hand injuries in an accredited FESSH emergency center during the lockdown in France (March 17 to May 10, 2020) due to the coronavirus outbreak. During this period, 1947 patients consulted for a hand injury. We found high percentages of men (63%), open wounds (70%), domestic accidents (88%) and surgical treatment being required (76%). There was a significant decrease in admissions and consultations relative to the same period in 2019. This reference data can help healthcare systems prepare for future outbreaks and similar restrictions.
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Affiliation(s)
- I Régas
- Institut de la Main Nantes Atlantique, Boulevard Charles-Gautier, 44800 Saint Herblain, France
| | - P Bellemère
- Institut de la Main Nantes Atlantique, Boulevard Charles-Gautier, 44800 Saint Herblain, France
| | - B Lamon
- Institut de la Main Nantes Atlantique, Boulevard Charles-Gautier, 44800 Saint Herblain, France
| | - Y Bouju
- Institut de la Main Nantes Atlantique, Boulevard Charles-Gautier, 44800 Saint Herblain, France
| | - F-A Lecoq
- Institut de la Main Nantes Atlantique, Boulevard Charles-Gautier, 44800 Saint Herblain, France
| | - C Chaves
- Institut de la Main Nantes Atlantique, Boulevard Charles-Gautier, 44800 Saint Herblain, France.
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Martin-Playa P, Calzacorta-Muñoz P, Aparicio Elizalde L, Carrera-Casal O, García Gutiérrez JJ. An overview of the situation of hand surgery in Spain during the peak of COVID-19 pandemic. HAND SURGERY & REHABILITATION 2020; 39:454-458. [PMID: 32619686 PMCID: PMC7326404 DOI: 10.1016/j.hansur.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 01/08/2023]
Abstract
Since the first cases were detected in China in December 2019, the COVID-19 pandemic has spread rapidly, collapsing many healthcare systems, and forcing them to adapt. Hand surgery has been indirectly affected by this scenario. This article aims to provide an overview on how Spanish hand surgeons have modified their daily practice. Based on a survey conducted nationwide, we observed a decrease in the number of emergency cases and cancellation of elective cases, shift to a more conservative treatment approach, use of personal protective equipment, and decrease in the number of outpatient visits and tests. Without definitive evidence at this point, knowing how we have dealt with the situation so far will help us adopt the needed measures to ensure both the patient's and surgeon's safety and manage available resources in future pandemics.
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Affiliation(s)
- P Martin-Playa
- Plastic and reconstructive surgery department, Cruces university hospital, plaza de Cruces s/n, 48903 Bilbao Biscay, Spain.
| | - P Calzacorta-Muñoz
- Plastic and reconstructive surgery department, Cruces university hospital, plaza de Cruces s/n, 48903 Bilbao Biscay, Spain
| | - L Aparicio Elizalde
- Plastic and reconstructive surgery department, Cruces university hospital, plaza de Cruces s/n, 48903 Bilbao Biscay, Spain
| | - O Carrera-Casal
- Plastic and reconstructive surgery department, Cruces university hospital, plaza de Cruces s/n, 48903 Bilbao Biscay, Spain
| | - J J García Gutiérrez
- Plastic and reconstructive surgery department, Cruces university hospital, plaza de Cruces s/n, 48903 Bilbao Biscay, Spain
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Kaliya-Perumal AK, Kharlukhi J, Omar UF. COVID-19 experience reports: an emerging trend in scholarly communication. Public Health 2020; 185:49-50. [PMID: 32544697 PMCID: PMC7266761 DOI: 10.1016/j.puhe.2020.05.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 12/02/2022]
Affiliation(s)
- A K Kaliya-Perumal
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore.
| | - J Kharlukhi
- Department of Paediatrics, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
| | - U F Omar
- Department of Orthopaedic Surgery, Al-Hekma Specialized Hospital, Assiut, Egypt; Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, Singapore
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11
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Pichard R, Kopel L, Lejeune Q, Masmoudi R, Masmejean EH. Impact of the COronaVIrus Disease 2019 lockdown on hand and upper limb emergencies: experience of a referred university trauma hand centre in Paris, France. INTERNATIONAL ORTHOPAEDICS 2020; 44:1497-1501. [PMID: 32488564 PMCID: PMC7264483 DOI: 10.1007/s00264-020-04654-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 05/26/2020] [Indexed: 01/08/2023]
Abstract
Purpose The lockdown imposed in France to cope with the COronaVIrus Disease 2019 (COVID-19) outbreak has led to major changes in the lifestyle of French citizens. The aim of our study was to study its impact on activity related to emergencies in hand and upper limb trauma in comparison to the same reference period in 2019. Material and methods All consecutive patients consulting for upper limb injury requiring urgent care at Georges-Pompidou European Hospital (HEGP), France, during the lockdown period (case group) and the equivalent period in 2019 (control group) were included. In each group, the type of accident, the anatomical location of the injury, and the treatment were reported and compared. Results Two hundred seventy-five patients were included in the case group in comparison to 784 patients in the control group. We observed a two-third decrease in the rate of upper limb emergencies (− 64.9%) in particular a drastic drop in the rate of road, work, and leisure accidents (10.4% vs 14.3%, p = 0.1151; 10.0% vs 22.6%, p < 0.0001; 13.1% vs 30.8%, p < 0.0001, respectively), and a clear increase in domestic accidents (66.5% vs 32.3%, p < 0.0001). The aetiologies were more dominated by lacerations of soft tissues (48.4%, vs 38.3%, p = 0.0034) and infections (8.7% vs 5.1%, p = 0.0299) with an increase in the indications for surgical management (51.2% vs 36.9%, p < 0.0001). Conversely, we observed fewer consultations for joint injuries (20.7% vs 30.7%, p = 0.0015) and fractures (22.2% vs 25.9%, p = 0.2210). Conclusion The lockdown imposed in France has changes the etiologies and the management of hand and upper limb emergencies.
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Affiliation(s)
- Rémy Pichard
- Hand, Upper Limb and Peripheral Nerve Surgery, Georges-Pompidou European Hospital (HEGP), 20 rue Leblanc, 75015, Paris, France. .,University of Paris, Paris, France.
| | - Luc Kopel
- Hand, Upper Limb and Peripheral Nerve Surgery, Georges-Pompidou European Hospital (HEGP), 20 rue Leblanc, 75015, Paris, France
| | - Quentin Lejeune
- Emergency Unit, Georges-Pompidou European Hospital (HEGP), Paris, France
| | - Rafik Masmoudi
- Emergency Unit, Georges-Pompidou European Hospital (HEGP), Paris, France
| | - Emmanuel H Masmejean
- Hand, Upper Limb and Peripheral Nerve Surgery, Georges-Pompidou European Hospital (HEGP), 20 rue Leblanc, 75015, Paris, France.,University of Paris, Paris, France.,Clinique Blomet, Research Unit, Paris, France
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Ducournau F, Gouzou S, Facca S, Liverneaux PA. Correspondence-COVID-19: Initial experience of hand surgeons in Northern Italy. HAND SURGERY & REHABILITATION 2020; 39:334-335. [PMID: 32387693 PMCID: PMC7204763 DOI: 10.1016/j.hansur.2020.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 12/04/2022]
Affiliation(s)
- F Ducournau
- Department of Hand Surgery, Strasbourg University Hospitals, FMTS, 1, avenue Molière, 67200 Strasbourg, France
| | - S Gouzou
- Department of Hand Surgery, Strasbourg University Hospitals, FMTS, 1, avenue Molière, 67200 Strasbourg, France
| | - S Facca
- Department of Hand Surgery, Strasbourg University Hospitals, FMTS, 1, avenue Molière, 67200 Strasbourg, France; Cube CNRS UMR7357, Strasbourg University, 2-4, rue Boussingault, 67000 Strasbourg, France
| | - P A Liverneaux
- Department of Hand Surgery, Strasbourg University Hospitals, FMTS, 1, avenue Molière, 67200 Strasbourg, France; Cube CNRS UMR7357, Strasbourg University, 2-4, rue Boussingault, 67000 Strasbourg, France.
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