Faria G, Virani S, Tadros B J, Dhinsa B S, Reddy G, Relwani J
Department of Orthopaedics, East Kent Hospitals University NHS Foundation Trust, Ashford, United Kingdom.
Malays Orthop J. 2021 Mar;15(1):100-104. doi: 10.5704/MOJ.2103.015.
COVID-19 has had a significant impact on the entire health system. The trauma and orthopaedic service has been compelled to alter working practices to respond proactively and definitively to the crisis. The aim of this study is to summarise the impact of this outbreak on the trauma and orthopaedic workload and outline the response of the department.
We retrospectively collected data comparing patient numbers pre-COVID-19, and prospectively during the early COVID-19 pandemic. We have collected the numbers and nature of outpatient orthopaedic attendances to fracture clinics and elective services, inpatient admissions and the number of fracture neck of femur operations performed.
The number of outpatient attendances for a musculoskeletal complaint to Accident and Emergency and the number of virtual fracture clinic reviews reduced by almost 50% during COVID-19. The number of face-to-face fracture clinic follow-ups decreased by around 67%, with a five-fold increase in telephone consultations. Inpatient admissions decreased by 33%, but the average number of fracture neck of femur operations performed has increased by 20% during COVID-19 compared to pre-COVID-19 levels.
We have noted a decrease in some aspects of the trauma and orthopaedic outpatient workload, such as leisure and occupational-related injuries but an increase in others, such as fracture neck of femurs. Many injuries have significantly reduced in numbers and we consider that a model could be developed for treating these injuries away from the acute hospital site entirely, thereby allowing the acute team to focus more appropriate major trauma injuries.
新型冠状病毒肺炎（COVID-19）对整个卫生系统产生了重大影响。创伤与骨科服务部门被迫改变工作方式，以积极、果断地应对这场危机。本研究的目的是总结此次疫情对创伤与骨科工作量的影响，并概述该科室的应对措施。
我们回顾性收集了COVID-19之前的患者数量数据，并前瞻性收集了COVID-19大流行早期的数据。我们收集了骨科门诊骨折诊所和择期服务的就诊人数及性质、住院人数以及股骨颈骨折手术的数量。
在COVID-19期间，因肌肉骨骼疾病前往急诊的门诊就诊人数以及虚拟骨折诊所复诊人数减少了近50%。面对面骨折诊所随访次数减少了约67%，电话咨询次数增加了五倍。住院人数减少了33%，但与COVID-19之前相比，COVID-19期间股骨颈骨折手术的平均数量增加了20%。
我们注意到创伤与骨科门诊工作量的某些方面有所减少，如与休闲和职业相关的损伤，但其他方面有所增加，如股骨颈骨折。许多损伤的数量显著减少，我们认为可以开发一种模式，将这些损伤的治疗完全转移到急症医院之外，从而使急症团队能够更专注于处理更合适的重大创伤。
