A Call to Arms: Emergency Hand and Upper-Extremity Operations During the COVID-19 Pandemic

Area of Science:

• Trauma Surgery
• Orthopedic Surgery
• Public Health

Background:

• Limited data exists on managing upper-extremity emergencies during societal restrictions.
• The COVID-19 pandemic introduced unprecedented social restrictions and duress.

Purpose of the Study:

• To investigate the impact of shelter-in-place orders on emergent operative upper-extremity surgery.
• To analyze trends in surgical volume and resource allocation for hand and arm emergencies.

Main Methods:

• Retrospective analysis of patients undergoing emergent/time-sensitive upper-extremity operations.
• Comparison of surgical volume, patient demographics, and injury patterns before and after shelter-in-place orders.
• Data collected from two geographically distinct Level I trauma centers.

Main Results:

• A 40% increase in operative volume for upper-extremity emergencies was observed post-shelter-in-place orders.
• High-energy fractures, nerve injuries, and infections were common indications for surgery.
• A significant rise in operations associated with high-risk behaviors (assaults, accidents) was noted.

Conclusions:

• Shelter-in-place orders correlated with an increased volume of emergent hand and upper-extremity surgeries.
• The surge in cases demanded substantial hospital resources.
• Increased high-risk behaviors contributed to the rise in surgical emergencies.