Fracture Surgery in Known COVID-19 Infected Patients: What Are the Challenges?

Abstract

Background: Surgery in the time of COVID-19 pandemic is a challenging issue while treatment of affected fracture<br />patients is inevitable. The present study summarizes the challenges that an orthopedic surgeon is confronting during<br />the surgical treatment of fracture patients with concomitant COVID-19 infection.<br />Methods: Demographic and fracture related data of 13 fracture patients with concomitant COVID-19 infection who<br />were treated with surgery was collected from three trauma centers in Tehran and Kermanshah cities from 21, February<br />2020 to April 3, 2020.<br />Results: All patients were male with mean age of 38.6±19.5 years. Eight patients had high energy fracture and seven<br />patients had multiple fractures and trauma. Wrist and hand were the common sites of fracture following hip and pelvis. The<br />mean interval time period between the diagnosis of COVID-19 infection and surgery was 2.3±1.5 days. Before surgery, all<br />patients except one had been admitted to the corona dedicated wards, while two patients were admitted to the intensive<br />care unit (ICU). One of the ICU admitted patients died. All the 12 alive patients remained in home isolation after discharge.<br />Conclusion: Fracture surgery in COVID-19 patients has many challenges such as lack of medical resources, delay<br />of surgery, medial staff fear, and patient isolation. However, a multidisciplinary approach using all potential hospital<br />resources would lead to successful operation and acceptable outcome.<br />Level of evidence: III