Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL.
J Orthop Trauma. 2020 Oct;34(10):e382-e388. doi: 10.1097/BOT.0000000000001924.
Orthopaedic trauma presents a unique and complex challenge in the initial phase of the coronavirus 2019 (COVID-19) global crisis. Little is currently known about the surgical practices in orthopaedic emergencies in the early days of the COVID-19 outbreak (1). This is a retrospective case series of 10 orthopaedic trauma patients who underwent fracture fixation in March 2020. Of the 10 patients testing COVID-19 positive, there were a total of 16 long bone fractures, 5 pelvic ring fractures, and 1 lumbar burst fracture. There were 7 (70%) males in this cohort. Two (20%) of the COVID-positive patients did not develop fever, leukocytosis, respiratory insufficiency, or positive imaging findings and were younger (average age 25.5 years) with fewer comorbidities (average 0.5) compared with the 8 symptomatic COVID-19-positive patients (56.6 years with 1.88 comorbidities). Advancement of COVID-19 pathogenesis with lung opacities and prolonged intubation occurred in all 5 patients who remained on ventilation postoperatively (range 9 hours-11 days). At the time of most recent follow-up, all patients survived, 1 continues to require ventilation support, 1 remains admitted without ventilation support, and 8 (80%) were discharged to home. LEVEL OF EVIDENCE:: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
在 2019 年冠状病毒（COVID-19）全球危机的初始阶段，骨科创伤带来了独特而复杂的挑战。目前对于 COVID-19 爆发初期（1）骨科急症的手术实践知之甚少。这是一项回顾性病例系列研究，共纳入 10 例 2020 年 3 月接受骨折固定的骨科创伤患者。在 10 例 COVID-19 检测呈阳性的患者中，共有 16 例长骨骨折、5 例骨盆环骨折和 1 例腰椎爆裂骨折。该队列中共有 7 名（70%）男性。这 2 名（20%）COVID-19 阳性患者未出现发热、白细胞增多、呼吸功能不全或影像学阳性发现，且年龄更小（平均年龄 25.5 岁），合并症更少（平均 0.5 种），与 8 名出现症状的 COVID-19 阳性患者（56.6 岁，合并症 1.88 种）相比具有显著差异。所有 5 名术后仍需呼吸机通气的患者（通气时间为 9 小时至 11 天）的 COVID-19 发病机制均进展为肺部混浊和延长插管。在最近一次随访时，所有患者均存活，1 例患者仍需呼吸机支持，1 例患者仍未接受呼吸机支持，8 例（80%）患者出院回家。证据水平：预后 II 级。有关证据水平的完整描述，请参见作者说明。
