Impact of the COronaVIrus Disease 2019 lockdown on hand and upper limb emergencies: experience of a referred university trauma hand centre in Paris, France

International Orthopaedics - Tập 44 - Trang 1497-1501 - 2020
Rémy Pichard1,2, Luc Kopel1, Quentin Lejeune3, Rafik Masmoudi3, Emmanuel H. Masmejean1,2,4
1Hand, Upper Limb and Peripheral Nerve Surgery, Georges-Pompidou European Hospital (HEGP), Paris, France
2University of Paris, Paris, France
3Emergency Unit, Georges-Pompidou European Hospital (HEGP), Paris, France
4Clinique Blomet, Research Unit, Paris, France

Tóm tắt

The lockdown imposed in France to cope with the COronaVIrus Disease 2019 (COVID-19) outbreak has led to major changes in the lifestyle of French citizens. The aim of our study was to study its impact on activity related to emergencies in hand and upper limb trauma in comparison to the same reference period in 2019. All consecutive patients consulting for upper limb injury requiring urgent care at Georges-Pompidou European Hospital (HEGP), France, during the lockdown period (case group) and the equivalent period in 2019 (control group) were included. In each group, the type of accident, the anatomical location of the injury, and the treatment were reported and compared. Two hundred seventy-five patients were included in the case group in comparison to 784 patients in the control group. We observed a two-third decrease in the rate of upper limb emergencies (− 64.9%) in particular a drastic drop in the rate of road, work, and leisure accidents (10.4% vs 14.3%, p = 0.1151; 10.0% vs 22.6%, p < 0.0001; 13.1% vs 30.8%, p < 0.0001, respectively), and a clear increase in domestic accidents (66.5% vs 32.3%, p < 0.0001). The aetiologies were more dominated by lacerations of soft tissues (48.4%, vs 38.3%, p = 0.0034) and infections (8.7% vs 5.1%, p = 0.0299) with an increase in the indications for surgical management (51.2% vs 36.9%, p < 0.0001). Conversely, we observed fewer consultations for joint injuries (20.7% vs 30.7%, p = 0.0015) and fractures (22.2% vs 25.9%, p = 0.2210). The lockdown imposed in France has changes the etiologies and the management of hand and upper limb emergencies.

Tài liệu tham khảo

Huang C, Wang Y, Li X et al (2020) Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395(10223):497–506. https://doi.org/10.1016/S0140-6736(20)30183-5 Guan W-J, Ni Z-Y, Hu Y et al (2020) Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 382:1708–1720. https://doi.org/10.1056/NEJMoa2002032 Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV) – 30 January 2020. https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov) WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19%2D%2D-11-march-2020 [dataset] Johns Hopkins University. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE): https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 Wu Z, McGoogan JM (2020) Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the chinese center for disease control and prevention. JAMA 323:1239–1242. https://doi.org/10.1001/jama.2020.2648 Ferguson N, Laydon D, Nedjati Gilani G, et al (2020) Report 9: impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand. Imperial College London. https://doi.org/10.25561/77482 Décret n° 2020–293 du 23 mars 2020 prescrivant les mesures générales nécessaires pour faire face à l’épidémie de covid-19 dans le cadre de l’état d’urgence sanitaire Gregory TM, Bihel T, Guigui P et al (2016) Terrorist attacks in Paris: surgical trauma experience in a referral center. Injury 47:2122–2126. https://doi.org/10.1016/j.injury.2016.08.014 Ministère des solidarités et de la santé (2020) Préparation à la phase épidémique de Covid-19. Établissements de santé Médecine de ville Établissements et services médico-sociaux. Guide Méthodologique Sarac NJ, Sarac BA, Schoenbrunner AR et al (2020) A review of state guidelines for elective orthopaedic procedures during the COVID-19 outbreak. J Bone Joint Surg Am 0(0):1–4. https://doi.org/10.2106/JBJS.20.00510 DePhillipo NN, Larson CM, O’Neill OR, LaPrade RF (2020) Guidelines for ambulatory surgery centers for the care of surgically necessary/time-sensitive orthopaedic cases during the COVID-19 pandemic. J Bone Joint Surg Am 0(0):1–4. https://doi.org/10.2106/JBJS.20.00489 Ghogawala Z, Kurpad S, Falavigna A et al (2020) Editorial. COVID-19 and spinal surgery. J Neurosurg Spine:1–3. https://doi.org/10.3171/2020.4.SPINE20468 Batteux F, Marty Chastan C, Cheritel C, Matalon H (2020) Tableau de bord Épidémie Covid-19 - Cellule de crise du 1er avril 2020 Direction APHP FESUM i.e. European Federation for emergency hand centers (fesum.fr) Masmejean EH, Faye A, Alnot JY, Mignon AF (2003) Trauma care systems in France. Injury 34:669–673. https://doi.org/10.1016/s0020-1383(03)00146-3 Farley KX, Aizpuru M, Boden SH, Wagner ER, Gottschalk MB, Daly CA (2019) Avocado-related knife injuries: describing an epidemic of hand injury. Am J Emerg Med. https://doi.org/10.1016/j.ajem.2019.06.051 Gunnell D, Appleby L, Arensman E et al (2020) Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry. https://doi.org/10.1016/S2215-0366(20)30171-1 Holmes EA, O’Connor RC, Perry VH et al (2020) Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry. https://doi.org/10.1016/S2215-0366(20)30168-1 Markus HS, Brainin M (2020) COVID-19 and stroke—a global world stroke organization perspective. Int J Stroke 0(0):1–4. https://doi.org/10.1177/1747493020923472 Ducournau F, Arianni M, Awwad S et al (2020) COVID-19: initial experience of an international group of hand surgeons. Hand Surg Rehabil 39:159–166. https://doi.org/10.1016/j.hansur.2020.04.001 Hwee J, Chiew J, Sechachalam S (2020) The impact of coronavirus disease 2019 (COVID-19) on the practice of hand surgery in Singapore. J Hand Surg. https://doi.org/10.1016/j.jhsa.2020.04.023 Facchin F, Messana F, Sonda R, Faccio D, Tiengo C, Bassetto F (2020) COVID-19: initial experience of hand surgeons in Northern Italy. Hand Surg Rehabil. https://doi.org/10.1016/j.hansur.2020.04.007 Mauffrey C, Trompeter A (2020) Lead the way or leave the way: leading a Department of Orthopedics through the COVID-19 pandemic. Eur J Orthop Surg Traumatol 30(4):555–557. https://doi.org/10.1007/s00590-020-02670-x Leibner ES, Stokes S, Ahmad D, Legome E (2020) Emergency department COVID management policies: one institution’s experience and lessons learned. Emerg Med Pract 22:1 BSSH. Wide Awake Hand Surgery Handbook v2 Guo X, Wang J, Hu D et al (2020) Survey of COVID-19 disease among orthopaedic surgeons in Wuhan, People’s Republic of China. J Bone Joint Surg Am. https://doi.org/10.2106/JBJS.20.00417 Rodrigues-Pinto R, Sousa R, Oliveira A (2020) Preparing to perform trauma and orthopaedic surgery on patients with COVID-19. J Bone Joint Surg Am. https://doi.org/10.2106/JBJS.20.00454 Awad ME, Rumley JCL, Vazquez JA, Devine JG (2020) Peri-operative considerations in urgent surgical care of suspected and confirmed COVID-19 orthopedic patients: operating rooms protocols and recommendations in the current COVID-19 pandemic. J Am Acad Orthop Surg. https://doi.org/10.5435/JAAOS-D-20-00227 Menendez ME, Jawa A, Haas DA, Warner JJP, Codman Shoulder Society (2020) Orthopedic surgery post COVID-19: an opportunity for innovation and transformation. J Shoulder Elb Surg 29:1083–1086. https://doi.org/10.1016/j.jse.2020.03.024 Grandizio LC, Foster BK, Klena JC (2020) Telemedicine in hand and upper-extremity surgery. J Hand Surg Am 45:239–242. https://doi.org/10.1016/j.jhsa.2019.09.007