A COMPARISON OF ORTHOPAEDIC TRAUMA CASES OPERATED ON DURING THE COVID-19 PANDEMIC WITH DIFFERENT PERIODS: A SINGLE CENTRE STUDY

Abstract

Introduction: To compare orthopaedic trauma cases treated surgically in our clinic during the COVID-19 pandemic in Turkey with surgically-treated trauma cases in previous periods, and to discuss these in the light of literature. Materials and Methods: Patient data of 3 different periods were compared. Group 1 included cases in the time period 11 March - 30 May, when the hospital was operating as a pandemic hospital for the COVID-19 pandemic in Turkey. Group 2 included cases from the equivalent time period the year before the pandemic, thought to have similar patient characteristics, and Group 3 covered the time period immediately before 11 March when COVID-19 was known in the world but there had not been any cases diagnosed in Turkey. Operations were performed in our clinic because of orthopaedic trauma to 186 patients in Group 1, to 262 patients in Group 2, and to 261 patients in Group 3. Results: A decrease of 29% was observed in trauma cases during the pandemic. In Group 1, 62 of 186 patients were aged >65 years, and 43 of these (69%) had a hip fracture. In Group 2, 33 (58%) patients aged >65 years underwent surgery for hip fracture and in Group 3, 60 (75%) patients. The time from hospital admission to surgery was mean 3.76±3.55 days in Group 1, 3.18±3.08 days in Group 2, and 2.68±2.33 days in Group 3 (p=0.017). The number of cases of attempted suicides was 6, 3, 3, respectively in the three groups (p=0.184). 30-day mortality was determined in 5, 3, and 4 cases, respectively (p=0.460). Conclusions: A decrease in the number of trauma cases was observed during the pandemic. However, there was no such decrease in hip fractures in elderly patients despite the quarantine of those aged >65 years. The workforce of the clinic was divided up during the pandemic for the diagnosis and follow-up of COVID-19 cases and thus there was no reduction in the workload of orthopedists as trauma surgery continued at the rate of 71%. Therefore, it can be considered very important to apply strict regulations which will decrease the risk of the spread of infection, and implement a multidisciplinary work flow for the more rapid discharge of trauma patients.

Keywords

• covid-19 pandemic
• trauma
• hip fracture
• quarantine.