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- Impact of COVID-19 pandemic and national lockdown in an orthopaedic and traumatology department—a comparison with the homologous period of 2019Publication . Ribau, Ana; Vale, João; Xará-Leite, Francisco; Rodrigues-Pinto, RicardoBackground: The coronavirus disease-2019 pandemic has forced health systems to undergo dynamic changes. This study aims to evaluate the impact of the pre-lockdown and of the lockdown period on the surgical activity of a Portuguese Orthopaedic and Traumatology Department and to compare it with the homologous period of 2019. Methods: The surgical activity between March 2 and May 2, 2020 and that of the homologous period of 2019 were analyzed and compared. Additionally, the impact of national and institutional measures was analyzed. Results: There was a decrease in elective surgeries, from 587 to 100. In 2020, 59.3% of all surgeries were urgent and 48.4% were trauma whereas in 2019 there were 25.5% urgent and 23.0% trauma surgeries (P < .001 and P < .001, respectively). There was no difference in the mean of proximal hip fractures operated per week (P = .310), even when analyzing only the lockdown period (P = .102). However, proximal hip fractures corresponded to significantly higher proportion of surgeries in 2020 (P = .04). Hand and tendon injuries significantly reduced in 2020, as were sports-related trauma surgeries. Mean number of days until surgery was significantly lower in 2020 (2020:1.6 ± 2.1, 2019: 2.2 ± 2.5, P = .012). Conclusion: Governmental and institutional measures had high impact on the production and on the epidemiology of trauma. While resumption of elective surgery is needed, lessons from these measures may help in the response to a possible second wave.
- Diminuição da exposição do cirurgião à radiação na cirurgia de ante-pé - posicionamento alternativo do doente e intensificador de imagemPublication . Xará-Leite, Francisco; Videira, Sara; Carrapatoso, Manuel; Barbosa, Tiago; Rodrigues, Claudia; Gonçalves, Isabel; Costa, LuisA exposição à radiação ionizante acarreta riscos para a saúde das equipas médicas. Este aspeto é particularmente relevante na cirurgia minimamente invasiva do pé devido ao posicionamento do doente e do cirurgião relativamente à fonte de radiação X. Durante o posicionamento “clássico” do doente, o C-arm e a equipa desconsideram alguns dos mais elementares princípios de segurança, particularmente nos centros com acesso mais limitado a aparelhos que utilizem baixas doses de radiação. A nossa técnica de posicionamento do doente permite uma redução da dispersão da radiação para o cirurgião e equipa médica, e os princípios de redução de exposição à radiação citados devem ser ponderados por todos aqueles que executam este tipo de técnicas na sua prática clínica regular.