RESUMO
Objectives: Many countries have implemented quarantines to control the Coronavirus (COVID-19) pandemic spread. The quarantine effects on surgically-treated fractures, operated during this period (March 9th - May 4th) in two public Greek institutions, the "Venizeleion" General Hospital of Crete (VGH) and the "251" Hellenic Air Force General Hospital of Athens ("251" HAFGH) were evaluated and compared with those of the same period of 2019. Materials and methods: This is a retrospective study of a prospectively collected database. Evaluated data included gender, age, and trauma mechanism. Outcomes: A total of 103 patients who had suffered fractures were surgically treated in both institutions during the quarantine period of 2020 compared to 179 during the same period of 2019, showing a reduction of 43% in surgical cases. The mean age of patients treated in 2020 was 72.2 (SD=19.9), as compared to 65.3 (SD=21.5; p-value=0.008) in 2019. There were 70 (68%) elderly patients (>65 years) in 2020 and 103 (57.6%) in 2019. Of all treated fractures, 31% were caused by high energy mechanisms during the explored period of 2020, as compared to 45% in 2019 (p-value=0.019). Conclusions: This is the first study in Europe evaluating the effect of COVID-19 quarantine on surgically treated fractures. The findings showed a significant decline in surgically treated fractures, particularly high-energy fractures, along with a significantly higher mean age of patients in 2020 compared to 2019. Low-energy fractures in elderly during quarantine emphasizes the need of prevention measures to minimize their incidence, especially in a time when the health personnel and resources are engaged in the battle against COVID-19.
RESUMO
Objectives: To investigate the differences in distribution of intracapsular and extracapsular hip fractures among genders and age groups treated surgically. Materials and methods: This is a nine-year retrospective cohort study. The type of hip fractures, age, and sex-related as well as overall incidence among 2 430 patients aged over 65, surgically treated at the "Venizeleio" General Hospital of Heraklion, Crete, Greece, were explored and evaluated. Outcomes: Women suffered hip fractures 2.9 times more often than men. The majority of patients hospitalized with hip fracture were above 75 years of age (62.3% in females and 59.3% in males). The proportion of extracapsular and intracapsular fractures were 59.6% and 40.4% in men and 62.7% and 37.2% in women, respectively. Extracapsular-intertrochanteric fractures were found to increase dramatically with age in women (from 52.3% in patients younger than 75 to 58.8% in those older than 75; p-value=0.007), while in men they slightly increased with age (57.7% in patients older than 75, compared to 55.7% in those less than 75; p-value=0.62). Conclusion: The pattern of hip fractures was found to differ between genders and age groups in the present patients' population. Most likely, these findings reflect differences in the nature and rate of bone loss, and frequency of falling events between males and females. It has become evident that the two main hip fracture types (extracapsular and intracapsular) are distinct clinical entities. Hence, they should be addressed independently in terms of underlying causes and prevention strategies.
