Background: This study assessed the impact of the COVID-19 pandemic on acute upper limb referrals and operative case-mix at the beginning and ease of British lockdown. Methods: A longitudinal multicentre observational cohort study was conducted for both upper limb trauma referrals and operative case-mix over a 12-week period (6 weeks from the beginning and 6 weeks from the ease of the national lockdown). Statistical analysis included median (± median absolute deviation), risk and odds ratios, and Fisher's exact test to calculate the statistical significance, set at p ≤ 0.05. Results: There was a 158% (n = 456 vs. 177) increase in upper limb referrals and 133% (n = 91 vs. 39) increase in the operative trauma caseload at the ease of lockdown compared with its commencement. An increase in sporting injuries was demonstrated (p=0.02), specifically cycling (p=0.004, OR=2.58). A significant increase in COVID-19 testing was demonstrated during the ease of lockdown (p=0.0001) with more patients having their management changed during the beginning of the pandemic (9.6% vs. 0.7%, p=0.0001). Of these patients, 47% went on to have delayed surgery within 6 months. No patients who underwent surgery tested positive for COVID-19 infection within 14 days post-operatively and no mortalities were recorded at 30 days. Conclusion: The ease of lockdown has seen upper limb referrals and operations more than double compared to early lockdown. With no patients testing positive for COVID-19 within 14 days of the procedure, this demonstrates that having upper limb surgery during the current pandemic is safe.
Background: This study assessed the impact of the COVID-19 pandemic on acute upper limb referrals and operative case-mix at the beginning and ease of British lockdown. Methods: A longitudinal multicentre observational cohort study was conducted for both upper limb trauma referrals and operative case-mix over a 12-week period (6 weeks from the beginning and 6 weeks from the ease of the national lockdown). Statistical analysis included median (± median absolute deviation), risk and odds ratios, and Fisher's exact test to calculate the statistical significance, set at p ≤ 0.05. Results: There was a 158% (n = 456 vs. 177) increase in upper limb referrals and 133% (n = 91 vs. 39) increase in the operative trauma caseload at the ease of lockdown compared with its commencement. An increase in sporting injuries was demonstrated (p=0.02), specifically cycling (p=0.004, OR=2.58). A significant increase in COVID-19 testing was demonstrated during the ease of lockdown (p=0.0001) with more patients having their management changed during the beginning of the pandemic (9.6% vs. 0.7%, p=0.0001). Of these patients, 47% went on to have delayed surgery within 6 months. No patients who underwent surgery tested positive for COVID-19 infection within 14 days post-operatively and no mortalities were recorded at 30 days. Conclusion: The ease of lockdown has seen upper limb referrals and operations more than double compared to early lockdown. With no patients testing positive for COVID-19 within 14 days of the procedure, this demonstrates that having upper limb surgery during the current pandemic is safe.
Authors: Catrin Morgan; Aashish K Ahluwalia; Arash Aframian; Lily Li; Stephen Ng Man Sun Journal: Br J Hosp Med (Lond) Date: 2020-04-10 Impact factor: 0.825
Authors: Shawn Diamond; Jonathan B Lundy; Erin L Weber; Shadi Lalezari; Gregory Rafijah; Amber Leis; Benjamin L Gray; Ines C Lin; Ranjan Gupta Journal: J Hand Surg Glob Online Date: 2020-05-29
Authors: Elizabeth M Curtis; Robert van der Velde; Rebecca J Moon; Joop P W van den Bergh; Piet Geusens; Frank de Vries; Tjeerd P van Staa; Cyrus Cooper; Nicholas C Harvey Journal: Bone Date: 2016-03-09 Impact factor: 4.398
Authors: Ingrid Arevalo-Rodriguez; Diana Buitrago-Garcia; Daniel Simancas-Racines; Paula Zambrano-Achig; Rosa Del Campo; Agustin Ciapponi; Omar Sued; Laura Martinez-García; Anne W Rutjes; Nicola Low; Patrick M Bossuyt; Jose A Perez-Molina; Javier Zamora Journal: PLoS One Date: 2020-12-10 Impact factor: 3.240