Correspondence-COVID-19: Initial experience of hand surgeons in Northern Italy.

Dear Sir,

We thank Facchin et al. for commenting [1] on our article [2] and for sharing their analysis. Nevertheless, we were surprised by certain qualitative and quantitative aspects of their hand surgery activity during the pandemic. Admittedly, the scheduled surgical procedures were completely stopped in their case as in ours, but their emergency activity was sustained whereas ours decreased considerably (Table 1 ).

Table 1

Comparison of hand surgical cases between 17th March and 17th April 2018 and 2020.

Bassetto study	9th March–9th April 2019		9th March–9th April 2020
	Home related	Work related	Home related	Work related
Minor procedurea/No immediate treatment needed	41	15	38	11
Major injuries requiring hospitalization/No immediate treatment needed	2	2	11	2
Revascularization or replantation	5	5	4	2
Total trauma cases	48	22	53	15
Elective hand surgeryb	47	0

Tendon repair, nerve repair, bone fixation, soft tissue reconstruction, infection drainage.

Carpal tunnel release, trigger finger, ganglion cyst removal, collagenase injection or fasciectomy for Dupuytren's disease.

To compare the change in 2020 hand surgery activity, we used 2018 data instead of 2019 data because our activity was artificially reduced in 2019 when we moved from one hospital to another. We used the period from March 17 to April 17 because it corresponds to the time when the selected activities were officially stopped in France.

The number of visits to our emergency hand department decreased from 1113 in 2018 to 282 in 2020, including 8 work-related accidents treated non-surgically and 17 treated surgically, of which there was 1 anterior wrist hemi-amputation and 1 ring finger avulsion that was amputated.

Unlike Facchin et al., we did not see occupational injuries requiring surgery during this same period. In addition, while we never transfer patients to another hospital in normal times, we were forced to transfer 4 patients to a private clinic in the city and refused 4 transfers from other hospitals because of a reduction in our access to operating rooms, which were being used by other surgical specialties.

We are grateful to Facchin et al. for sharing their Northern Italy experience.

Dislcosure of interest

Philippe Liverneaux has competing interests with Newclip Technics et Argomedical.

The other authors declare that they have no competing interest.