Surgical approach for management of Pertrochanteric fractures of proximal femur or hip in patients with COVI D-19

Background: Since the onset of the COVID-19 pandemic, adverse outcomes in patients with orthopaedic surgery have become a major concern for surgeons. In other words, the question remains whether surgery should be postponed until the patient is fully recovered or whether early surgery should be performed. Objectives: The present study sought to answer the above questions by examining the consequences of pertrochanteric fractures of the proximal femur or hip surgery in CVOID-19 patients and comparing the findings with non-COVID-19 patients. Methods: The present study reports the experience of orthopaedic surgeons on patients with pertrochanteric fractures of the proximal femur or hip candidates for surgery admitted between May and July 2020, who were divided into two groups of patients with COVID-19 (n=12) and non- COVID-19 patients (n=24). The outcomes of the surgery were determined based on the duration of surgery, time interval between surgery to complete recovery, and duration of hospitalization in the intensive care unit (ICU). Results: Comparing the postoperative outcomes across the two groups with and without COVID-19 showed no significant difference in mean time required for the patient to recover after surgery (p=0.160) or mean operation time (p=0.648). However, the length of ICU stay in those who were infected with SARS-CoV-2 was significantly longer than that observed in the non-COVID-19 group (p = 0.018) due to the need for more care and not because of postoperative complications. Conclusion: Surgical approach on fractures in patients with COVID-19 can be performed with high confidence and safety, and therefore, such surgeries should not be delayed in these patients.