Treatment of distal femur fractures in patients with COVID-19 coronavirus infection

Abstract

Annotation. Treatment of patients with fractures of the distal part of the hip against the background of COVID-19 is an extremely difficult task, since the course of this infection in injured patients has a complicated course. The purpose of our work was to evaluate the results of treatment of patients with fractures of the distal part of the hip against the background of COVID-19 during the epidemic period. To carry out our study, a retrospective analysis of 73 patients with fractures in the distal part of the hip, who were treated in one of the city hospitals of Kyiv, was carried out. The observation period was from 04.20.2020 to 06.20.2021. The criterion for participation in the study was the presence of a fracture of the distal part of the hip in combination with the new coronavirus infection COVID-19. All patients underwent a PCR study and a multispiral SCT, which was part of the general clinical examination of patients. Statistical substantiation of the research was carried out using Microsoft Excel. To make a correct comparison, we chose the method of calculating the coefficient of the Pearson polychoric relationship indicator. In the study group, conservative treatment was offered to 15 patients (20.5%), whose average age was 77.2±2.6 years. It should be noted that in 60.0% of patients who were prescribed conservative treatment, lung damage was detected at the level of 50% or higher, that is, a severe degree of coronavirus infection. Conservative treatment was not successful in 6 patients who died in the hospital, hospital mortality was 40.0%. Surgical treatment was performed in 58 patients, which was 79.4%. Treatment of patients with fractures of the distal part of the hip against the background of COVID-19 has many problems, both of a medical and organizational nature. Operative treatment of patients with distal hip fractures against the background of COVID-19 is a higher priority than conservative treatment, as indicated by a decrease in the number of complications, early mobilization of patients and a decrease in in-hospital mortality. Surgical fixation of fractures of the distal part of the hip and rapid mobilization of patients with COVID-19 affects the reduction of respiratory disorders and is a priority method in the treatment of this category of patients.