In early 2020 the evolving COVID-19 Pandemic provided the world and medical community with a generational challenge. As a novel disease, countries were left with strategic decisions and many went into social lockdown. Initial resources and research were directed at upscaling internal medicine and intensive care services, understanding the disease pathophysiology, and testing treatments. It soon became evident that COVID-19 had multi-system effects at it's worst. In orthopaedics one of the most vulnerable groups to COVID-19 were the elderly, specifically those who suffered fractured neck of femur at this time. More literature is needed urgently if we are to understand and mitigate the negative impacts in this group of patients. This observational study assesses the early morbidity and mortality of patients with this diagnosis during the evolving COVID-19 Pandemic.
Many elderly patients admitted to hospitals during the evolving COVID-19 pandemic after falls
or being generally unwell, were considered to have a possible diagnosis of COVID-19. This was
extremely relevant to the subgroup of patients who suffered from fractured neck of femurs
during this time, with most of them elderly, frail, and more likely to have multiple
co-morbidities. COVID-19 was considered a precipitating factor for falls, but also
anecdotally, an indicator of potentially poor recovery and rehabilitation.
With regards to orthopaedic and trauma surgery, a limited amount of literature is available
pertaining to COVID-19 and specifically it's potential effects on patient outcomes in
patients requiring surgery.
We performed a multi centre observational study across London, United Kingdom, looking at the
demographics and details of patients admitted with fractured neck of femur during the
evolving pandemic. All data collected was non identifiable. Data was also collected as to the
COVID-19 status of these patients, either positive or negative. Data was analysed to assess
the morbidity and mortality of this patient group and search for any prognostic factors.
Other: Surgery: Dynamic Hip Screw, hemiarthroplasty, hip replacement, intramedullary nail
If fit for anaesthesia patients may undergo relevant procedure for fractured neck of femur as per NICE guidelines within limitations of resources as defined by BOAST
Inclusion Criteria:
- Fractured neck of femur
- Received operative intervention for fractured neck of femur
Exclusion Criteria:
- open fracture
- fracture of femoral shaft
- periprosthetic fracture
- revision surgery
Barts Health NHS Trust
London, United Kingdom
Babar Kayani, MBBS, Principal Investigator
Barts & The London NHS Trust