The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jun 2020
Treatment of Proximal Femoral Fragility Fractures in Patients with COVID-19 During the SARS-CoV-2 Outbreak in Northern Italy.
From February 20 to April 2020, the coronavirus SARS (severe acute respiratory syndrome)-CoV-2 spread in northern Italy, drastically challenging the care capacities of the national health care system. Unprepared for this emergency, hospitals have quickly reformulated paths of assistance in an effort to guarantee treatment for infected patients. Orthopaedic departments have been focused on elderly traumatology, especially the treatment of femoral neck fractures in patients with coronavirus disease-2019 (COVID-19). The purpose of the present study was to evaluate the orthopaedic management strategy for femoral fragility fractures in COVID-19-positive patients with the hypothesis that operative treatment may contribute to the overall stability of the patient. ⋯ Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jun 2020
Randomized Controlled TrialEducation Increases Disposal of Unused Opioids After Total Joint Arthroplasty: A Cluster-Randomized Controlled Trial.
Unused opioid pills are a danger to patients and their loved ones as they may be diverted for abuse or misuse. The purpose of this study was to determine the baseline rate of proper disposal of unused opioids among patients undergoing total joint arthroplasty and to determine how education impacts disposal rates. ⋯ The rate of opioid disposal is very low after total joint arthroplasty. Education on opioid disposal more than triples opioid disposal rates compared with no education. To help to prevent diversion of unused opioid pills, all patients who undergo total joint arthroplasty should be educated on the proper disposal of unused opioids.
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J Bone Joint Surg Am · Jun 2020
Review Multicenter StudyA Review of State Guidelines for Elective Orthopaedic Procedures During the COVID-19 Outbreak.
The SARS-CoV-2 (COVID-19) pandemic has resulted in widespread cancellation of elective orthopaedic procedures. The guidance coming from multiple sources frequently has been difficult to assimilate as well as dynamic, with constantly changing standards. We seek to communicate the current guidelines published by each state, to discuss the impact of these guidelines on orthopaedic surgery, and to provide the general framework used to determine which procedures have been postponed at our institution. ⋯ Few states have published guidelines specific to orthopaedic surgery during the COVID-19 outbreak, leaving hospital systems and surgeons with the responsibility of balancing the benefits of surgery with the risks to public health.