Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;13(1):12-17.
doi: 10.1177/1758573220977028. Epub 2020 Dec 6.

COVID-19 - Changes in the presentation and management of shoulder and elbow trauma in a UK district general hospital orthopaedic department

Giles Faria  1 , Siddharth Virani  1 , Mohammed Shaeir  1 , Patricia Velazquez-Ruta  1 , Baha John Tadros  1 , Georgios Arealis  1 , Baljinder Singh Dhinsa  1 , Jai Relwani  1
Affiliations

COVID-19 - Changes in the presentation and management of shoulder and elbow trauma in a UK district general hospital orthopaedic department

Giles Faria et al. Shoulder Elbow. 2021 Feb.

Abstract

Introduction: COVID-19 has had a significant impact on healthcare systems. We aim to quantify the impact of this outbreak on shoulder and elbow trauma in our institution.

Methods: We prospectively collected data on patients presenting to our hospital with shoulder and elbow injuries during COVID-19. This included the number of attendances to the emergency department, fracture clinic, inpatient admissions and operative treatments. This was compared to a pre-COVID-19 period. We also assessed the efficacy of telephone clinics.

Results: There has been a noticeable decrease in the number of emergency department and fracture clinic attendances with upper limb complaints. The number of in-person fracture clinic reviews also decreased, with a reciprocal exponential increase in telephone consultations. We recorded a decrease in the number of shoulder and elbow trauma procedures performed. There was a small increase in the proportion of injuries treated conservatively during COVID-19. Our telephone clinics yielded a diagnosis and management plan in many cases and patient perspective appeared favourable.

Conclusion: We have noted significant change in the upper limb caseload. Certain injuries have reduced, likely due to COVID-19 lockdown. Moreover, we consider several changes to current practices could be taken forward after the pandemic.

Keywords: COVID; elbow; response; shoulder; trauma.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Showing presentations to Accident and Emergency and minor injury departments across the trust with an upper limb complaint.
Figure 2.
Figure 2.
Comparison of decline in upper limb injuries to lower limb injuries.
Figure 3.
Figure 3.
Trends of upper limb presentations pre-COVID-19 measures and during COVID-19 measures.
Figure 4.
Figure 4.
Number of patients reviewed in the fracture clinic with an upper limb complaint.
Figure 5.
Figure 5.
Risk stratification algorithm for treatment of fractures and other injuries to minimise hospital exposure.
See this image and copyright information in PMC

References

    1. Chang Liang Z, Wang W, Murphy D, et al. Novel coronavirus and orthopaedic surgery: early experiences from Singapore. J Bone Joint Surg Am 2020; 102: 745–749. - PMC - PubMed
    1. https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infec... 2020 (accessed 14 June 2020).
    1. https://www.boa.ac.uk/uploads/assets/ee39d8a8-9457-4533-9774e973c835246d... 2020 (accessed 14th June 2020).
    1. Yeh HC, Turner RS, Jones RK, et al. Characterization of aerosols produced during surgical procedures in hospitals. Aerosol Sci Technol 1995; 22: 151–161.
    1. Wölfel R, Corman VM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019. Nature 2020; 581: 465–469. - PubMed

LinkOut - more resources