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三级医院在 COVID-19 大流行期间处理和呈现髋部转子间骨折。

Manejo y presentación de las fracturas transtrocantéricas de cadera durante la pandemia de COVID-19 en un hospital de tercer nivel de atención.

机构信息

Servicio de Cadera, Hospital de Traumatología y Ortopedia Doctor y General Rafael Moreno Valle, Secretaría de Salud, Puebla, Puebla, México.

出版信息

Cir Cir. 2023;91(3):368-374. doi: 10.24875/CIRU.22000399.

Abstract

BACKGROUND

The prevalence of intertrochanteric hip fractures is approximately 30%. The usual management of hip fractures is performed by dynamic hip screw (DHS) or central medullary nailing (CMN). The COVID-19 pandemic has changed medical treatment guidelines in all specialties around the world.

OBJECTIVE

To recognize the prevalence and management of unstable trochanteric hip fractures during the COVID-19 pandemic.

METHOD

An observational study was conducted in a third-level care hospital in patients with fractures of type AOOTA 31A2.1 and A2.2 managed with CMN or DHS. The management trends by orthopedic surgeons were analyzed.

RESULTS

The prevalence during 2019 was 38%, in 2020 it was 21.3% and in 2021 it was 32.6%. The male-to-female ratio found was 1:1.7. The age was 66.48 ± 21.6 years (range: 17-92). Of orthopedic surgeons surveyed, 80.4% preferred CMN.

CONCLUSIONS

The prevalence decreased during 2020. The treatment trend during the pandemic was higher for the DHS system; the use of CMN decreased by 86%. The treatment of intertrochanteric hip fractures was influenced due to the COVID-19 pandemic towards a cheaper method.

摘要

背景

转子间髋部骨折的患病率约为 30%。髋部骨折的常规治疗方法是采用动力髋螺钉(DHS)或髓内钉(CMN)。COVID-19 大流行改变了全球所有专业的医疗治疗指南。

目的

认识 COVID-19 大流行期间不稳定转子间髋部骨折的流行情况和治疗方法。

方法

对在三级护理医院接受治疗的 AOOTA 31A2.1 和 A2.2 型骨折患者进行观察性研究,这些患者采用 CMN 或 DHS 进行治疗。分析骨科医生的治疗趋势。

结果

2019 年的患病率为 38%,2020 年为 21.3%,2021 年为 32.6%。男女比例为 1:1.7。患者平均年龄为 66.48 ± 21.6 岁(范围:17-92 岁)。在接受调查的骨科医生中,80.4%的人更喜欢 CMN。

结论

2020 年患病率下降。大流行期间的治疗趋势是 DHS 系统更高;CMN 的使用率下降了 86%。由于 COVID-19 大流行,转子间髋部骨折的治疗方法转向了更便宜的方法。

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