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Otremski H, Dermott J, Page K, Ipp LS, Blanco JS, Studer D, Sigal A, Kim D, Hasler CC, Lebel DE, Widmann RF, Ovadia D. The global impact of the COVID-19 pandemic on pediatric spinal care: A multi-centric study. J Child Orthop 2024; 18:33-39. [PMID: 38348438 PMCID: PMC10859112 DOI: 10.1177/18632521231210356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/08/2023] [Indexed: 02/15/2024] Open
Abstract
Background The COVID-19 pandemic has affected healthcare worldwide since December 2019. We aimed to identify the effect of the COVID-19 pandemic on outpatient clinic and surgical volumes and peri-operative complications for pediatric spinal deformities patients. Methods In this multi-center retrospective study, outpatient visits (in-person and virtual care) and pediatric spine surgeries volumes in four high-volume pediatric spine centers were compared between March and December 2019 and the same period in 2020. Peri-operative complications were collected and compared in the same periods. Descriptive statistics were calculated, and comparative analyses were performed. Results During the 2020 study period, the outpatient visit (in-person and virtual care) volume decreased during local lockdown periods by 71% for new patients (p < 0.001) and 53% for returning patients (p = 0.03). Overall, for 2020, there was a 20% reduction in new patients (p = 0.001) and 21% decrease in returning patients (p < 0.001). During the pandemic, there was also 20% less overall surgical volume of adolescent idiopathic scoliosis (AIS) patients undergoing primary posterior spinal fusion, with a 70% reduction during lockdown times (p < 0.001). Complication rate and profile were similar between periods. Conclusion There was a significant decrease in outpatient pediatric spine outpatient visits, particularly new patients, which may increase the proportion of pediatric patients with spinal deformities that present late, meeting surgical indication. This, in combination with the reduction in surgical volume of AIS over the first year of the pandemic, could result in an extended waitlist for surgeries during years to come. Complication rate was similar for both periods, suggesting it is safe to continue elective pediatric spine surgery even in a time of a pandemic. Level of evidence level IV.
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Affiliation(s)
- Hila Otremski
- Pediatric Orthopaedic Department, Dana Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jennifer Dermott
- The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kira Page
- Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Lisa S Ipp
- Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - John S Blanco
- Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Daniel Studer
- Orthopaedic Department, Children’s Hospital, University of Basel, Basel, Switzerland
| | - Amit Sigal
- Pediatric Orthopaedic Department, Dana Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorothy Kim
- The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carol C Hasler
- Orthopaedic Department, Children’s Hospital, University of Basel, Basel, Switzerland
| | - David E Lebel
- The Hospital for Sick Children, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Roger F Widmann
- Department of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Dror Ovadia
- Pediatric Orthopaedic Department, Dana Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Impact of the COVID-19 pandemic on the well-being of preschoolers: A parental guide. Heliyon 2023; 9:e14332. [PMID: 36974319 PMCID: PMC10028354 DOI: 10.1016/j.heliyon.2023.e14332] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 02/13/2023] [Accepted: 02/28/2023] [Indexed: 03/24/2023] Open
Abstract
Unexpected changes brought about by the coronavirus disease 2019 (COVID-19) have affected humans worldwide. This review attempts to address major parental concerns about the development of preschool-aged children during the pandemic from the perspectives of neuropsychology, consultation, and motor development for preschoolers aged 2–5 years. Methods A total of 273 articles including original data, review articles, national and regional perspectives, government websites, and commentaries were considered in this review, of which 117 manuscripts were excluded because they were unrelated to children, adolescents, or COVID -19 pandemic/upper respiratory infections. A total of 156 manuscripts were included after reading the abstract and entire article. Results Telehealth could be an effective tool for addressing cognitive and emotional challenges that arise during the pandemic. Online consultations are highlighted for nutritional guidelines and to overcome problems that parents face when caring for children in difficult times. Outdoor activities using sanitisers, proper cleanliness, and following standard operating procedures are recommended. Parental preoccupation with media should be avoided. Interpretation: Many preschoolers show delays in reaching their developmental milestones, and the pandemic has increased parents' concerns, as access to practitioners is limited. Therefore, parents should be encouraged to undergo neuropsychological consultations whenever necessary. This study emphasises important strategies to ensure that children's development is minimally affected while staying in the confined environment of their homes. This study serves as a new guide for parents, as they raise young children in the new normal. Parents should undergo basic yearly physical, neuropsychological, nutritional, and speech checkups.
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Utomo P, Wirawan MY, Kumara HC, Yudistira MB. Changes in Pediatric Fracture Cases during the Coronavirus Disease 2019 Pandemic: Data from a National Referral Orthopedic Hospital in Indonesia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: This study aims to compare the impact of coronavirus disease 2019 (COVID-19) on pediatric fracture services in a national referral orthopedic hospital in Indonesia to understand the service provisions that may be required during the pandemic.
METHODS: The study compared the population group during 1 year of the COVID-19 pandemic in Indonesia to the same period 1 year before. This cross-sectional study was performed in Prof. Dr. R Soeharso Orthopedic Hospital, Surakarta, Indonesia, from March 2019 to February 2021. The subjects were pediatric fracture patients aged 0–18 years. Patients recorded on other orthopedic service support installations such as radiology, laboratory, or physiotherapy and diagnosed with any other orthopedic sub-specialty were excluded.
RESULTS: A total of 1787 patients were recorded in this study, with the mean of pediatric fracture patients during the pre-COVID-19 period was 90.75 (standard deviation [SD]: 28.5) and during the COVID-19 period was 58.16 (SD: 19.17) monthly. In the 1st year of the pandemic, there was a significant reduction in clinical visits compared to the same period in 2019 (p < 0.005).
CONCLUSION: There were significant differences in pediatric fracture cases clinic visits and patients’ length of stay in the COVID-19 period than before the COVID-19 occurred.
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Melander S, Almström J, Enlund G, Frykholm P. The COVID-19 pandemic first wave in Sweden: A national registry study of the effects on pediatric anesthesia and surgery. Paediatr Anaesth 2021; 31:846-853. [PMID: 33971054 PMCID: PMC8242453 DOI: 10.1111/pan.14203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/28/2021] [Accepted: 05/04/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic is pushing healthcare systems to their limits. Dramatic reductions in the adult elective surgery are ubiquitous, but corresponding changes in pediatric services are not well described. The Swedish Perioperative Registry contains data on all anesthetic procedures in Sweden, and therefore, provides a unique opportunity to analyze the effect of the pandemic on the pediatric anesthesia capacity on a national level. We hypothesized that there would be a significant reduction in pediatric elective procedures. The aim was to determine the effects on pediatric surgical and anesthetic services during the first wave of the COVID-19 pandemic in Sweden. METHODS For this retrospective registry cohort study, we extracted all procedures performed on patients <18 years of age in 2020 and 2019. Weeks 12 to 26 of 2020 were defined as the first wave, and data were analyzed according to level of care, type of surgery, procedure code, and emergency or elective surgery. RESULTS We found 7015 fewer procedures during the first wave epoch. Elective cases were reduced by 53.7% while emergency surgery was not significantly affected. During the peak of the first wave in April, there was a 72.8% reduction in elective cases; ENT/maxillofacial surgery showed the greatest reduction (86.7%). The surgical and anesthesia capacity recovered to near-normal levels by the end of June 2020. CONCLUSION We conclude that the impact of COVID-19 on pediatric surgical procedures in Sweden during the first wave of the pandemic was dramatic, but elective services were restored a few months after the peak.
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Affiliation(s)
- Sixten Melander
- Department of Surgical SciencesSection of Anaesthesia and Intensive Care MedicineUppsala UniversityUppsalaSweden
| | - Jimmy Almström
- Department of Surgical SciencesSection of Anaesthesia and Intensive Care MedicineUppsala UniversityUppsalaSweden
| | - Gunnar Enlund
- Department of Surgical SciencesSection of Anaesthesia and Intensive Care MedicineUppsala UniversityUppsalaSweden
| | - Peter Frykholm
- Department of Surgical SciencesSection of Anaesthesia and Intensive Care MedicineUppsala UniversityUppsalaSweden
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Özbay H, Toy S, Polat O. The impact of Covid-19 pandemic related lockdown on clubfoot practice: Type of study design: Retrospective cross-sectional study. Medicine (Baltimore) 2021; 100:e26389. [PMID: 34160419 PMCID: PMC8238334 DOI: 10.1097/md.0000000000026389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/27/2021] [Accepted: 05/25/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT We investigated whether the number of pediatric patients with congenital clubfoot treated with the Ponseti method decreased during the Covid-19 pandemic or not in a rural area. So we aimed to guide orthopedic surgeons and health infrastructure for future pandemics to be prepared in hospitals of rural areas for the treatment of children with congenital clubfoot.One hundred and fifty-four patients with clubfoot who were admitted to our clinic were evaluated retrospectively from March 2017 to December 2020. Institutional hospital electronic database was used to detect the number of weeks between the birth and first cast performed in clinic and the number of casts been applied and unilaterality or bilaterality. Patients were divided into four groups, which included pandemic period and three previous years. Recorded data were analyzed statistically to detect if there is a difference between the numbers of the patients in pandemic period and three previous years.The number of patients with clubfoot admitted to our hospital between March 2020 and December 2020 increased by 140% compared to previous year. There was a statistically significant difference between the average number of cast applications of Group 4 and other groups (P <.001). Achilles tenotomy was performed in 44 (61.1%) of 72 patients admitted during the pandemic period. Only 4 (13.3%) out of 30 patients admitted between March 2019 and December 2019 were performed Achilles tenotomy.We detected an increase in the number of clubfoot cases admitted to our rural-based hospital during the Covid-19 pandemic, treated with casting or surgically. We think this is because of preventive measures during the pandemic, which caused parents could not reach urban for treatment.
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Trisolino G, Toniolo RM, Marengo L, Dibello D, Guida P, Panuccio E, Evangelista A, Stallone S, Sansò ML, Amati C, Costici PF, Boero S, Farsetti P, De Sanctis N, Verdoni F, Memeo A, Gigante C. Resilience Against COVID-19: How Italy Faced the Pandemic in Pediatric Orthopedics and Traumatology. CHILDREN (BASEL, SWITZERLAND) 2021; 8:530. [PMID: 34206218 PMCID: PMC8305147 DOI: 10.3390/children8070530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND We aimed to investigate the variation of medical and surgical activities in pediatric orthopedics in Italy, during the year of the COVID-19 pandemic, in comparison with data from the previous two years. The differences among the first wave, phase 2 and second wave were also analyzed. METHODS We conducted a retrospective multicenter study regarding the clinical and surgical activities in pediatric orthopedics during the pandemic and pre-pandemic period. The hospital databases of seven tertiary referral centers for pediatric orthopedics and traumatology were queried for events regarding pediatric orthopedic patients from 1 March 2018 to 28 February 2021. Surgical procedures were classified according to the "SITOP Priority Panel". An additional classification in "high-priority" and "low-priority" surgery was also applied. RESULTS Overall, in 2020, we observed a significant drop in surgical volumes compared to the previous two years. The decrease was different across the different classes of priority, with "high-priority" surgery being less influenced. The decrease in emergency department visits was almost three-fold greater than the decrease in trauma surgery. During the second wave, a lower decline in surgical interventions and a noticeable resumption of "low-priority" surgery and outpatient visits were observed. CONCLUSION Our study represents the first nationwide survey quantifying the impact of the COVID-19 pandemic on pediatric orthopedics and traumatology during the first and second wave.
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Affiliation(s)
- Giovanni Trisolino
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, IRCCS, 40136 Bologna, Italy;
| | - Renato Maria Toniolo
- Department of Orthopaedics and Traumatology, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy;
| | - Lorenza Marengo
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Giannina Gaslini, IRCCS, 16147 Genova, Italy; (L.M.); (S.B.)
| | - Daniela Dibello
- Unit of Pediatric Orthopaedics and Traumatology Giovanni XXIII Children’s Hospital, University of Bari, 70126 Bari, Italy; (D.D.); (C.A.)
| | - Pasquale Guida
- Unit of Pediatric Orthopaedics and Traumatology, Azienda Ospedaliera di Rilievo Nazionale Santobono Pausillipon, 80122 Napoli, Italy; (P.G.); (M.L.S.)
| | - Elena Panuccio
- Department of Paediatric Orthopaedics and Traumatology, Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, 20122 Milano, Italy; (E.P.); (A.M.)
| | - Andrea Evangelista
- Unit of General Affairs, Istituto Ortopedico Rizzoli, IRCCS, 40136 Bologna, Italy;
| | - Stefano Stallone
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, IRCCS, 40136 Bologna, Italy;
| | - Maria Lucia Sansò
- Unit of Pediatric Orthopaedics and Traumatology, Azienda Ospedaliera di Rilievo Nazionale Santobono Pausillipon, 80122 Napoli, Italy; (P.G.); (M.L.S.)
| | - Carlo Amati
- Unit of Pediatric Orthopaedics and Traumatology Giovanni XXIII Children’s Hospital, University of Bari, 70126 Bari, Italy; (D.D.); (C.A.)
| | - Pier Francesco Costici
- Orthopedic Unit, Department of Surgery, Bambino Gesù Children’s Hospital, IRCCS, 00050 Rome, Italy;
| | - Silvio Boero
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Giannina Gaslini, IRCCS, 16147 Genova, Italy; (L.M.); (S.B.)
| | - Pasquale Farsetti
- Department of Orthopaedics Surgery, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Nando De Sanctis
- Unit of Pediatric Orthopaedics and Traumatology, Campolongo Hospital, 84025 Marina di Eboli, Italy;
| | - Fabio Verdoni
- Unit of Pediatric Orthopaedics and Traumatology, Istituto Galeazzi, IRCCS, 20161 Milan, Italy;
| | - Antonio Memeo
- Department of Paediatric Orthopaedics and Traumatology, Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, 20122 Milano, Italy; (E.P.); (A.M.)
| | - Cosimo Gigante
- Pediatric Orthopaedic Unit, Department of Woman and Child Health, Padua General Hospital, 35121 Padua, Italy;
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Oguzkaya S, Misir A, Ozcamdalli M, Eken G, Kizkapan TB, Kurk MB, Uzun E. Impact of the COVID-19 pandemic on orthopedic fracture characteristics in three hospitals in Turkey: A multi-center epidemiological study. Jt Dis Relat Surg 2021; 32:323-332. [PMID: 34145802 PMCID: PMC8343845 DOI: 10.52312/jdrs.2021.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/12/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives
In this study, we present the use of case specific three- dimensional (3D) printed plastic models and custom-made acetabular implants in orthopedic surgery. Materials and methods
Between March 2018 and September 2020, surgeries were simulated using plastic models manufactured by 3D printers on the two patients with pilon fractures. Also, custom-made acetabular implants were used on two patients with an acetabular bone defect for the revision of total hip arthroplasty (THA). Results
More comfortable surgeries were experienced in pilon fractures using preoperative plastic models. Similarly, during the follow-up period, the patients that applied custom-made acetabular implants showed a fixed and well-positioning in radiographic examination. These patients did not experience any surgical complications and achieved an excellent recovery. Conclusion
Preoperative surgical simulation with 3D printed models can increase the comfort of fracture surgeries. Also, custom-made 3D printed acetabular implants can perform an important task in patients treated with revision THA surgery due to severe acetabular defects.
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Affiliation(s)
- Sinan Oguzkaya
- Sarkışla Devlet Hastanesi Ortopedi ve Travmatoloji Kliniği, 58400 Sarkışla, Sivas, Türkiye.
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Oguzkaya S, Misir A, Ozcamdalli M, Eken G, Kizkapan TB, Kurk MB, Uzun E. Impact of the COVID-19 pandemic on orthopedic fracture characteristics in three hospitals in Turkey: A multi-center epidemiological study. Jt Dis Relat Surg 2021. [PMID: 34145807 PMCID: PMC8343834 DOI: 10.52312/jdrs.2021.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objectives
The aim of this study was to evaluate the impact of novel coronavirus-2019 (COVID-19) on the epidemiological characteristics of orthopedic fractures. Patients and methods
A total of 2,960 patients (1,755 males, 1,205 females; mean age: 39.6 years; range, 1 to 98 years) with orthopedic fractures were included in the study: 552 patients during the pandemic period (March 10th and July 1st, 2020) and 1,158 control patients in the same period 2019 and 1,250 control patients in 2018. Epidemiological characteristics, injury mechanisms, fracture locations and treatment details of the patients were analyzed and compared between 2018, 2019 and 2020 for adult and pediatric populations. Results
Of a total of 552 patients, 485 were adults and 67 were pediatric patients. In the control groups, of 1,158 patients (2019), 770 were adults and 378 were pediatric patients and, of 1,250 patients (2018), 857 were adults and 393 were pediatric patients. The proportion of proximal femur and hand fractures significantly increased during the pandemic period (p=0.025 and p=0.038, respectively). The most frequent surgical indication in the pandemic period was proximal femoral fracture. The proportion of home accidents as an injury mechanism significantly increased in the pandemic period compared to 2018 and 2019 (48.5% vs. 18.6% and 20.6%, respectively; p=0.000). The proportion of female pediatric patients significantly increased during the pandemic period compared to 2018 and 2019 (44.8% vs. 25.4% and 27.2%, respectively, p=0.004). The proportion of forearm fractures (p=0.001) also increased, and the proportion of tibia-fibula fractures (p=0.03) decreased. The most frequent surgical indication in pediatric patients was distal humeral fracture in both groups. Conclusion
During the pandemic period, proximal femoral fractures in the elderly remained a concern. In-home preventative strategies may be beneficial to reduce the incidence of hip fractures in the elderly.
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Affiliation(s)
- Sinan Oguzkaya
- Sarkışla Devlet Hastanesi Ortopedi ve Travmatoloji Kliniği, 58400 Sarkışla, Sivas, Türkiye.
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