The Impact of COVID-19 on Neck of Femur Fracture Care: A Major Trauma Centre Experience, United Kingdom

Document Type : RESEARCH PAPER

Authors

1 1 Department of Trauma and Orthopeadics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, United Kingdom 2 School of Clinical Medicine, University Of Cambridge, Cambridge, United Kingdom

2 Department of Trauma and Orthopeadics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, United Kingdom

3 Department of Trauma and Orthopeadics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, United Kingdom- Department of Orthogeriatrics, Addenbrookes Hospital, United Kingdom

Abstract

Background: The aim of this study was to investigate the impact of the COVID-19 pandemic on the management and
outcome of patients with neck of femur fractures.
Methods: Data was collected for 96 patients with neck of femur fractures who presented to the emergency department
between March 1, 2020 and May 15, 2020. This data set included information about their COVID-19 status.
Parameters including inpatient complications, hospital quality measures, mortality rates, and training opportunities
were compared between the COVID-19 positive and COVID-19 negative groups. Furthermore, our current cohort of
patients were compared against a historical control group of 95 patients who presented with neck of femur fractures
before the COVID-19 pandemic.
Results: Seven (7.3%) patients were confirmed COVID positive by RT-PCR testing. The COVID positive cohort, when
compared to the COVID negative cohort, had higher rates of postoperative complications (71.4% vs 25.9%), increased
length of stay (30.3 days vs 12 days) and quicker time to surgery (0.7 days vs 1.3 days).
The 2020 cohort compared to the 2019 cohort, had an increased 30-day mortality rate (13.5% vs 4.2%), increased
number of delayed cases (25% vs 11.8%) as well as reduced training opportunities for Orthopaedic trainees to perform
the surgery (51.6% vs 22.8%).
Conclusion: COVID-19 has had a profound impact on the care and outcome of neck of femur fracture patients during
the pandemic with an increase in 30-day mortality rate. There were profound adverse effects on patient management
pathways and outcomes while also affecting training opportunities.
Level of evidence: VI

Keywords

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The Archives of Bone and Joint Surgery
Volume 9, Issue 4
July and August 2021
Pages 453-460

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History

  • Receive Date: 14 July 2020
  • Revise Date: 06 September 2020
  • Accept Date: 28 September 2020

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