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This article provides a brief overview of the current COVID-19 pandemic crisis and the impact on trauma and orthopaedic surgeons. The principles of protect, avoid, restrict and abbreviate are recommended. Coordination of response, communication and support are also important. The versatility of orthopaedic surgeons lends them to having an important role.
RESUMO
Vitamin D is required for calcium homeostasis and bone metabolism. This prospective observational study examined the incidence of vitamin D deficiency amongst patients with a fracture of the femoral neck, and the correlation between pre-admission use of bone-protection medication and vitamin D levels. Vitamin D assays were available in 75 out of 151 patients admitted with a hip fracture in February-March 2012; the assays were performed within one week of admission and surgery. The incidence of suboptimal vitamin D levels was 90% (68/75), with severe deficiency (<15nmol/l) or deficiency (<30nmol/l) seen in 71% (53/75). Only 7 patients were on bone protection medication at the time of admission, and all of them had suboptimal vitamin D levels. This suggests that the prevention is practically inexistent or at best insufficient. According to the literature, vitamin D deficiency is also associated with falls and maybe with outcome of surgery. Current management strategies may not be sufficient to address vitamin D deficiency and are overlooking an important and potentially modifiable risk factor.