Surgical management during three phases of covid-19 pandemic with changing role of thoracic computerized tomography imaging in orthopaedic patient management: Lessons learned by orthopaedic surgeon

Gaurav Govil, L. Tomar, Pawan Dhawan
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Abstract

The coronavirus (Covid-19) pandemic has ravaged the whole world. It had affected the allied surgical branches that had to reinvent the protocols for patient management. Trauma being inevitable, needed urgent attention. The changing perspectives had a defining role in the direction of arthroplasty too.The pandemic has been considered into three different phases: 1. The acute phase of the lockdown; 2. The intermediate phase of surgical prioritization; 3. The late phase of surgical management post-vaccination.We deliberate on the impact of the pandemic on orthopaedic surgery and the role of Thoracic computerized tomography (Th-CT) imaging during Covid-19 on the surgical practice of orthopaedic surgeons. Th-CT had been useful imaging during the acute phase of lockdown in the pandemic to identify the asymptomatic Covid-19 infection and to gauge the severity of viral infection. We reviewed the guidelines formulated during each step and identified the lessons learned by the practicing orthopaedic surgeon. We further elaborate on the changes in the usage of Th-CT in the subsequent intermediate and late phases of the pandemic for orthopaedic surgeons. The critical consideration remained to achieve an uneventful recovery during the orthopaedic surgical management, to avoid the transmissibility of infection to the surgeon, and to protect the patient from the high morbidity and mortality of Covid-19 related illness. The Covid-19 pandemic has instigated orthopaedists to develop a holistic approach to deal with the new challenges during this pandemic era.
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2019冠状病毒病大流行三个阶段的外科管理与胸部计算机断层成像在骨科患者管理中的作用变化:骨科医生的经验教训
新冠肺炎疫情席卷全球。它影响了联盟外科分支,不得不重新制定病人管理方案。创伤是不可避免的,需要紧急治疗。视角的改变对关节置换术的方向也起着决定性的作用。本次大流行被认为分为三个不同的阶段:封锁的急性期;2. 手术优先排序的中间阶段;3.疫苗接种后手术处理的后期。我们讨论了大流行对骨科手术的影响以及Covid-19期间胸部计算机断层扫描(Th-CT)成像对骨科医生手术实践的作用。在大流行期间的急性封锁阶段,Th-CT在识别无症状的Covid-19感染和衡量病毒感染的严重程度方面是有用的成像。我们回顾了在每个步骤中制定的指导方针,并确定了实践骨科医生学到的经验教训。我们进一步阐述了在随后的大流行中后期骨科医生使用Th-CT的变化。在骨科手术治疗过程中,关键的考虑因素仍然是实现平稳恢复,避免感染传播给外科医生,并保护患者免受Covid-19相关疾病的高发病率和死亡率。2019冠状病毒病大流行促使骨科医生制定一种整体方法来应对大流行时期的新挑战。
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