COVID-19大流行前的髋关节手术

Ortho-tips Pub Date : 1900-01-01 DOI:10.35366/94523
D. E. G. Zertuche, José Alfredo Vásquez Paniagua, Alfonso Chávez Valenzuela, Jonathan Achoy Inzunza
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引用次数: 0

摘要

选择性骨科手术、初级关节置换术和关节镜检查均受到大流行的影响。大多数需要髋关节手术的患者都是高龄患者,髋关节镜检查患者除外。这些患者表现出功能储备和免疫系统改变的合并症,可能会更严重地受到COVID-19感染的影响,必须只选择那些病理可能留下重要后遗症或危及身体健康的患者。脱臼和脓毒性髋关节关节炎被认为是外科急症,因为如果不治疗就会出现并发症,需要在8小时内进行治疗。髋部骨折是需要立即住院治疗的急症,由于手术时间、出血量和器械数量减少,必须使用动态髋螺钉代替重建钉。当疫情处于平稳期时,将恢复关节镜等选择性手术,评估住院时间不超过23小时的可能性,只要该单位有专门的区域来照顾阴性患者,并计算可用的呼吸机以应对任何可能的情况。一旦最大传染高峰过去,就可以进行选择性全髋关节置换术,我们确信我们的医疗基础设施可以支持COVID-19感染的新增加。
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Cirugía de cadera ante la pandemia COVID-19
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 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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