The effect of surgical treatment in patients with proximal hip fractures during the COVID-19 pandemic

Abstract

Annotation. The aim of our study was to provide a clinical description of the diagnostic process, surgical treatment tactics and its impact on treatment outcomes in patients with proximal femur fractures and COVID-19 infection. In our study, we analyzed the treatment of 43 patients with fractures of the proximal femur who were treated in one of the city hospitals of Kyiv in the period from September 2020 to March 2021. For screening of COVID-19, all patients with fractures of the proximal part of the hip planned for surgical treatment were sent for reverse transcription polymerase chain reaction (RT-PCR) analysis for the qualitative detection of SARS-CoV-2 nucleic acid. in swabs from the nasopharynx. Upon admission, 40 patients (93.0%) had symptoms characteristic of COVID-19, namely: headache, general weakness, subfebrile temperature, shortness of breath. In 7.0% of patients with proximal hip fractures, asymptomatic course of the disease of COVID-19 was detected, however, in the diagnostic process, the diagnosis was still made. Statistical processing was carried out using a non-parametric method, the method of calculating the coefficient of the Pearson polychoric relationship indicator was chosen. In all observation groups, an improvement in the general condition and laboratory parameters was noted already on the 3rd day of the postoperative period. A fracture of the proximal part of the hip is an injury that can threaten the patient's life, so the choice of the surgical intervention method and its timing play a key role in the recovery of this category of patients. An increase in the time of bed rest, connection of hypostatic phenomena, extension of the period of pain sensitivity can lead to deterioration of the condition of patients infected with COVID-19. Based on our research, we came to the conclusion that early surgical treatment of patients with fractures of the proximal part of the hip and COVID-19 has a positive effect on the general condition of patients, quickly mobilizes them, improves lung ventilation, which are factors of recovery.