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Órgano Oficial de Difusión Científica de la Federación Mexicana de Colegios de Ortopedia y Traumatología, A.C. (FEMECOT)

2020, Number 3

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Ortho-tips 2020; 16 (3)

Hip surgery in the face of the COVID-19 pandemic

Garín ZDE, Penagos PJA, Chávez VA, Achoy IJ

Language: Spanish
References: 24
Page: 112-120
PDF size: 148.69 Kb.


ABSTRACT

Elective orthopedic surgery, primary articular replacements and arthroscopies have been affected by the pandemic. Most patients that require a hip surgery are from advanced age, with the exception of hip arthroscopy patients. These patients show comorbidities with alterations in their functional reserves and immune system by which they can be more severely affected by a COVID-19 infection, must be selected only the ones where the pathology could leave important sequels or risk their physical wellbeing. Dislocations and septic hip arthritis are considered surgical urgencies due to the complications that can present if they are not treated, by which they require attention within eight hours. Hip fractures are urgencies that require immediate hospitalization and must be treated within the first 24-48 hours. The treatment for intracapsular fractures by osseous fragility, hemiarthroplasty is recommended. For extracapsular fractures, the use of dynamic hip screw instead of reconstruction nails because of the decrease in surgical time, amount of bleedings and less amount of instruments. Resumption of elective surgeries like arthroscopies will be made when the pandemic situation is in a stage of plateau, evaluating the possibility of having a hospital stay of less than 23 hours, as long as the unit has a specialized area to care for negative patients and count with available ventilators for any eventuality. Elective total hip replacements could be performed once the maximum contagion peak has passed and we are sure that our medical attention infrastructure can support a new rise in COVID-19 infections.


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