Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
J Bone Joint Surg Am. 2020 Jul 1;102(13):1116-1122. doi: 10.2106/JBJS.20.00532.
The SARS-CoV-2 (severe acute respiratory syndrome-coronavirus 2) was reported in Wuhan, Hubei Province, People's Republic of China, and, subsequently, in other provinces and regions across the People's Republic of China and >212 countries. COVID-19, the disease caused by this coronavirus, was declared a worldwide pandemic by the World Health Organization (WHO). The incidence of patients with fracture who are also positive for COVID-19 is on the rise. The diagnosis and management of such patients can be complicated as their clinical characteristics are heterogeneous. Furthermore, a surgical procedure can be particularly challenging given that the use of high-speed devices results in aerosol generation. In this study, we develop and propose globally applicable guidelines to fill this knowledge gap and we identify and propose the necessary protective strategies for medical personnel in an orthopaedic emergency department and in the inpatient wards. We also introduce diagnostic criteria, surgical complication management, and follow-up strategies for infected patients. These guidelines may be helpful to decrease the infection rate of orthopaedic trauma personnel and to provide diagnosis and treatment therapy for patients with fracture and COVID-19.
新型冠状病毒(SARS-CoV-2)于中国湖北省武汉市首次报告,随后在中国其他省份和 212 个国家和地区也有报道。由这种冠状病毒引起的疾病被世界卫生组织(WHO)宣布为全球大流行。同时患有 COVID-19 的骨折患者的发病率正在上升。由于此类患者的临床特征具有异质性,因此其诊断和管理可能较为复杂。此外,由于高速设备的使用会产生气溶胶,因此手术过程特别具有挑战性。在这项研究中,我们制定并提出了全球适用的指南,以填补这一知识空白,并确定并提出了骨科急诊室和住院病房医务人员所需的防护策略。我们还介绍了感染患者的诊断标准、手术并发症管理和随访策略。这些指南可能有助于降低骨科创伤人员的感染率,并为 COVID-19 合并骨折患者提供诊断和治疗。