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. 2022 Jan 17:12:21514593211036785.
doi: 10.1177/21514593211036785. eCollection 2021.

Impact of Sars-Cov-2 pandemic on hip fractures: Clinical and radiographic outcomes

Fernando García-Seisdedos Pérez-Tabernero  1 , Santiago Gabardo Calvo  1 , Gonzalo Luengo-Alonso  1 , Myriam Rodríguez Couso  2 , Emilio Calvo  1
Affiliations

Impact of Sars-Cov-2 pandemic on hip fractures: Clinical and radiographic outcomes

Fernando García-Seisdedos Pérez-Tabernero et al. Geriatr Orthop Surg Rehabil. .

Abstract

Introduction: Hip fractures affecting older people are at a higher risk of complications during the SARS-CoV-2 pandemic. The aim of this study is to provide data about proximal femoral fractures management and early outcomes during COVID-19 pandemic compared to the same period in 2019. Material and Methods: Retrospective and comparative study performed in two different periods were analyzed: from March 15, 2020, to April 30, 2020 (the first six weeks of Spain´s current confinement) and the same period in 2019. Data regarding demographics (age and sex, housing), type of fracture, surgical performance, early outcomes (at 30 days), and at 1-year follow-up were collected. A total of 146 patients were evaluated, 89 in 2019 and 57 in 2020. Results: Despite the drop ∼35.6% in hip fractures during SARS-CoV-2 period, distribution (age (P = 0.985), sex (P = 0.43), housing (P = 0.61), type of fracture (P = 0.41)) and Charlson comorbidity index (P = 0.12) were similar to a 2019 period. Surgical performance did not worsen in spite of the tough situation and the use of personal protective equipment, improving in some radiological variables (tip-to-apex and calcar reduction). In terms of postoperative outcomes, although there is a tendency to a short-term mortality increase (from 3.4% to 5.2%, P = 0.22), there were no differences at 1-year follow-up (20.2% in 2019 and 20.4% in 2020, P=0.587). In the same line, although in both groups the patients lost functionality at 1 year, there were no significant differences (P = 0.42). Conclusion: Even in challenging times, protocols and adequate organization ensure proper outcomes, reaching satisfying clinical and surgical outcomes during the COVID-19 pandemic, despite an increasing trend in short term mortality not seen at 1-year follow-up.

Keywords: SARSCOV-2; fragile patient; hip fracture; orthogeriatrics.

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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.
Example of reduction measurement in a anteroposterior radiograph, analyzing both Tip-Apex distance and position of the cephalic screw in the femoral neck (inferior, middle or inferior).
Figure 2.
Figure 2.
Example of varus–valgus stem position evaluation in a anteroposterior radiograph.
Figure 3.
Figure 3.
Functional ambulation classification (FAC) scale.
See this image and copyright information in PMC

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