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General Orthopaedics

OUTCOME OF ORTHOPAEDIC TRAUMA SURGERIES DURING THE PEAK AND PLATEAU OF COVID-19 PANDEMIC: AN ASSESSMENT OF MARGIN OF SAFETY

The British Indian Orthopaedic Society (BIOS) Annual Scientific Meeting, Cardiff, Wales, 2–3 July 2021.



Abstract

Abstract

Background

This study aims to estimate the risk of acquiring a medical complication or death from COVID-19 infection in patients who were admitted for orthopaedic trauma surgery during the peak and plateau of pandemic. Unlike other recently published studies, where patient-cohort includes a more morbid group and cancer surgeries, we report on a group more akin to those having routine elective orthopaedic surgery.

Methods

The study included 214 patients who underwent orthopaedic trauma surgeries in the hospital between 12th March and 12th May 2020 when the COVID-19 pandemic was on the rise in the United Kingdom. Data was collected on demographic profile including comorbidities, ASA grade, COVID-19 test results, type of procedures and any readmissions, complications or mortality due to COVID-19.

Results

There were 7.9% readmissions and 52.9% of it was for respiratory complications. Only one patient had positive COVID-19 test during readmission. 30-day mortality for trauma surgeries was 0% if hip fractures were excluded and 2.8% in all patients. All the mortalities were for neck of femur fracture surgeries and between ASA Grade 3 and 4 or in patients above the age of 70 years.

Conclusion

This study suggests that presence of COVID-19 virus in the community and hospital did not adversely affect the outcome of orthopaedic trauma surgeries or lead to excess mortality or readmissions in patients undergoing limb trauma surgery. The findings also support resumption of elective orthopaedic surgeries with appropriate risk stratification, patient optimization and with adequate infrastructural support amidst the recovery phase of the pandemic.