Fracture Surgery in Known COVID-19 Infected Patients: What Are the Challenges?



1 Department of Orthopedic Surgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Joint Reconstruction Research Center (JRRC), Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran

3 Department of Orthopedic Surgery, Imam Hossein Hospital,Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Orthopedic Surgery, Kermanshah University of Medical Sciences, Kermanshah Iran


Background: Surgery in the time of COVID-19 pandemic is a challenging issue while treatment of affected fracture
patients is inevitable. The present study summarizes the challenges that an orthopedic surgeon is confronting during
the surgical treatment of fracture patients with concomitant COVID-19 infection.
Methods: Demographic and fracture related data of 13 fracture patients with concomitant COVID-19 infection who
were treated with surgery was collected from three trauma centers in Tehran and Kermanshah cities from 21, February
2020 to April 3, 2020.
Results: All patients were male with mean age of 38.6±19.5 years. Eight patients had high energy fracture and seven
patients had multiple fractures and trauma. Wrist and hand were the common sites of fracture following hip and pelvis. The
mean interval time period between the diagnosis of COVID-19 infection and surgery was 2.3±1.5 days. Before surgery, all
patients except one had been admitted to the corona dedicated wards, while two patients were admitted to the intensive
care unit (ICU). One of the ICU admitted patients died. All the 12 alive patients remained in home isolation after discharge.
Conclusion: Fracture surgery in COVID-19 patients has many challenges such as lack of medical resources, delay
of surgery, medial staff fear, and patient isolation. However, a multidisciplinary approach using all potential hospital
resources would lead to successful operation and acceptable outcome.
Level of evidence: III