Thibaut Fortané1, Michael Bouyer2, Malo Le Hanneur3, Baptiste Belvisi4, Guillaume Courtiol5, Kevin Chevalier5, Caroline Dainotto5, Marie Loret2, Agathe Kling2, Antonin Bentejac2, Thibault Lafosse2. 1. Hand, Upper Limb, Brachial Plexus, and Microsurgery Unit (PBMA), Clinique Générale d'Annecy, 4 Chemin de la Tour la Reine, 74000 Annecy, France. Electronic address: tfortane@gmail.com. 2. Hand, Upper Limb, Brachial Plexus, and Microsurgery Unit (PBMA), Clinique Générale d'Annecy, 4 Chemin de la Tour la Reine, 74000 Annecy, France. 3. Department of Orthopedics and Traumatology - Service of Hand, Upper Limb and Peripheral Nerve Surgery, Georges Pompidou European Hospital (HEGP), Assistance Publique Hôpitaux de Paris - Paris Descartes University, 20 rue Leblanc, 75015 Paris, France. 4. Orthopedic Surgery Department, Centre Hospitalier Annecy Gennevois (CHANGE), Metz-Tessy, France. 5. Emergency department, Clinique Générale d'Annecy, 4 Chemin de la Tour la Reine, 74000 Annecy, France.
Abstract
INTRODUCTION: hand injuries are a common emergency mainly caused by domestic accidents or sport injuries. During the COVID-19 pandemic confinement period, with a cut off in transportation as well as in occupational and physical activities, we observed a decrease in medical and elective surgical activities but emergency cases of upper limb and hand surgery increased. MATERIALS AND METHODS: we conducted a retrospective epidemiological study to analyze two periods between the same dates in 2019 and 2020, for all the duration of the confinement period. We compared the numbers of consultations in the emergency department, elective surgeries, hand and upper limb emergency cases in our center and urgent limb surgeries in the nearby hospital. Then we compared the mechanisms and severity of injuries and the type of surgery. RESULTS: between 2019 and 2020 there was a decrease of consultations in the emergency department in our institution of 52%, a decrease of total elective surgeries of 75%, a decrease in surgeries for urgent peripheral limb injuries of 50%, whereas the hand and upper limb emergency remained stable or even increased by 4% regard to occupational and domestic accidents. There was a significant difference in the mechanism of injury with an increase of domestic accident and a decrease of occupational, road traffic and sport accidents. Severity of the injuries increased, with augmentation of the number of tissues involved and longer expected time of recovery. CONCLUSION: during the confinement period of the COVID-19 pandemic, despite an important reduction of medical activities, the amount and severity of hand emergency cases increased. A specific plan regarding duty shift organization for hand trauma should be maintained regardless of the sanitary situation.
INTRODUCTION: hand injuries are a common emergency mainly caused by domestic accidents or sport injuries. During the COVID-19 pandemic confinement period, with a cut off in transportation as well as in occupational and physical activities, we observed a decrease in medical and elective surgical activities but emergency cases of upper limb and hand surgery increased. MATERIALS AND METHODS: we conducted a retrospective epidemiological study to analyze two periods between the same dates in 2019 and 2020, for all the duration of the confinement period. We compared the numbers of consultations in the emergency department, elective surgeries, hand and upper limb emergency cases in our center and urgent limb surgeries in the nearby hospital. Then we compared the mechanisms and severity of injuries and the type of surgery. RESULTS: between 2019 and 2020 there was a decrease of consultations in the emergency department in our institution of 52%, a decrease of total elective surgeries of 75%, a decrease in surgeries for urgent peripheral limb injuries of 50%, whereas the hand and upper limb emergency remained stable or even increased by 4% regard to occupational and domestic accidents. There was a significant difference in the mechanism of injury with an increase of domestic accident and a decrease of occupational, road traffic and sport accidents. Severity of the injuries increased, with augmentation of the number of tissues involved and longer expected time of recovery. CONCLUSION: during the confinement period of the COVID-19 pandemic, despite an important reduction of medical activities, the amount and severity of hand emergency cases increased. A specific plan regarding duty shift organization for hand trauma should be maintained regardless of the sanitary situation.
Authors: Doha Obed; Mustafa Salim; Tekoshin Ammo; Maria M Gildt; Nicco Krezdorn; Peter M Vogt; Khaled Dastagir Journal: Ann Med Surg (Lond) Date: 2022-09-15