Effects of easing shelter-in-place restrictions and the lingering COVID-19 pandemic on orthopaedic trauma at a community level 2 trauma center.

OBJECTIVES: Evaluate the effect of easing "shelter-in-place" restrictions and coronavirus-2019 (COVID-19) cases on orthopaedic trauma encounters (OTEs) at a community level II trauma center. METHODS: A retrospective analysis was conducted of OTEs from March-June of 2016 to 2020. Injuries were classified by high or low severity. Admission and surgical intervention rates were also compared year to year. Data were statistically analyzed and compared with external data for traffic counts near the hospital and COVID-19 cases in Michigan as well as a timeline for enacting and easing of shelter-in-place orders in the state of Michigan. RESULTS: There was no difference in the number of OTEs May to June, 2020 compared with the average of those same months 2016 to 2019. March to June, 2020 showed no change in proportion of injury severity, admissions, or surgical interventions when compared with the average of March-June, 2016 to 2019, although the overall quantity of each was decreased in March and April. A significant negative correlation was found between the daily number of COVID-19 cases in Michigan and OTEs. CONCLUSIONS: The quantity of OTEs normalized to pre-COVID-19 levels in May and June of 2020 compared with 2016 to 2019 despite a previously documented 45.1% drop in March and April. A negative correlation was noted between the number of reported Michigan COVID-19 cases and volume of OTEs. There were no significant changes noted to admission rates or rates of surgical intervention on OTEs throughout the time period studied.

Effect of Shelter-in-Place Orders and the COVID-19 Pandemic on Orthopaedic Trauma at a Community Level II Trauma Center.

OBJECTIVES: To evaluate the effect of the COVID-19 pandemic and the "shelter-in-place" order on orthopaedic trauma presenting to a community level II trauma center. It is hypothesized that the overall number of orthopaedic trauma encounters (OTEs), the number of OTEs related to both high and low severity injuries, and the proportion of OTEs related to high severity versus low severity injuries decreased compared with previous years. METHODS: A retrospective analysis was conducted of OTEs between 2016 and 2020. High and low severity OTEs were classified according to an algorithm created by the researchers. Data were statistically analyzed and compared with external data for traffic counts, motor vehicle accidents, and Transportation Security Administration checkpoints. RESULTS: A 45.1% decrease (P = 0.0005) was seen in OTEs from March and April 2016-2019 compared with 2020. The decrease began approximately 12 days before the shelter-in-place order. There was a 58.8% decrease in high severity injuries with a fracture (P = 0.013) and a 42.9% decrease in low severities injuries (P = 0.0003). The proportion of high to low severity OTEs was unchanged. CONCLUSIONS: The quantity of OTEs was significantly affected by the COVID-19 pandemic and Michigan shelter-in-place order. A decrease in both high and low severity OTEs was found; however, there was no statistically significant change in the ratio of high to low severity OTEs compared with previous years. Although it is difficult to determine what portion of the decrease in OTE is attributable to the shelter-in-place order versus the COVID-19 pandemic in general, data suggest both play a role. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of Levels of Evidence.

Introduction of a Combined Gastrointestinal Histopathology Laboratory Exercise into an Undergraduate Medical School Curriculum.

To improve training in histology and pathology, an integrative, case-based histopathology laboratory exercise that used virtual microscopy was offered to first-year medical students during the KCOM gastrointestinal block. Students showed improvement in their understanding of histology and pathology after completing the exercise. Most students agreed that the combined histopathology laboratory helped them improve their understanding of histology and pathology in the gastrointestinal system and link normal histological and pathological changes to better understand disease processes.

Histological characteristics of knee menisci in patients with osteoarthritis.

Existing data indicate knee menisci in patients with osteoarthritis (OA) show tearing, maceration, and fragmentation, but little is known about the change in histological structure. The aim of this study was to evaluate the change in the menisci histological structure in patients with clinically diagnosed knee OA. Fourteen patients undergoing surgical treatment of knee OA (OA group) and 14 cadaveric knees (control group) were assessed. Demographic data, medical history, synovial fluid, OA severity, medial meniscus (MM) tissue, and lateral meniscus (LM) tissue were collected from the OA group. Three nonconsecutive 10 µm cross-sectional tissue slices of menisci were analyzed for percentage of tissue calcification. Exact Mann-Whitney tests and Spearman correlation coefficients tested for relationships between variables. The major change in the histological structure of the menisci in patients with OA was calcification of the matrix, which was significantly greater in the OA group compared with the control group for MM (OA: 11.9%, cadaver: 5.17%; P < 0.001) and LM tissues (OA: 11.1%, cadaver: 4.2%; P < 0.001). A correlation between percent calcification of the MM and LM tissues existed in the OA group (ρ = 0.56, P = 0.04) but not the control group (P = 0.20). The most pronounced pathological change in the histology of menisci was calcification of the cartilage matrix, significantly greater in the OA group than the control group. A strong correlation between percent calcification of MM and LM tissues in patients with OA indicates changes in fibrocartilage matrix of menisci progress similarly in the medial and lateral compartments of the knee. Clin. Anat. 30:805-810, 2017. © 2017Wiley Periodicals, Inc.

Premedical anatomy experience and student performance in medical gross anatomy.

Gross anatomy is considered one of the most important basic science courses in medical education, yet few medical schools require its completion prior to matriculation. The effect of taking anatomy courses before entering medical school on performance in medical gross anatomy has been previously studied with inconsistent results. The effect of premedical anatomy coursework on performance in medical gross anatomy, overall medical school grade point average (GPA), and Comprehensive Osteopathic Medical Licensing Examination Level 1 (COMLEX 1) score was evaluated in 456 first-year osteopathic medical students along with a survey on its perceived benefits on success in medical gross anatomy course. No significant differences were found in gross anatomy grade, GPA, or COMLEX 1 score between students with premedical anatomy coursework and those without. However, significant differences and higher scores were observed in students who had taken three or more undergraduate anatomy courses including at least one with cadaveric laboratory. There was significantly lower perceived benefit for academic success in the medical gross anatomy course (P<.001) from those students who had taken premedical anatomy courses (5.9 of 10) compared with those who had not (8.2 of 10). Results suggest that requiring any anatomy course as a prerequisite for medical school would not have significant effect on student performance in the medical gross anatomy course. However, requiring more specific anatomy coursework including taking three or more undergraduate anatomy courses, one with cadaveric laboratory component, may result in higher medical gross anatomy grades, medical school GPA, and COMLEX 1 scores. Clin. Anat. 30:303-311, 2017. © 2017 Wiley Periodicals, Inc.