Objective: Operating duties for orthopaedic surgeons decreased during the COVID-19 pandemic, while Emergency Department (ED) cases surged. Orthopaedic Walk-In Clinics (OWICs) were implemented to manage urgent musculoskeletal cases.
Methods: OWICs, organized in three days, were staffed by one orthopaedic surgeon, one triage person, three medical assistants, and a physician assistant/nurse practitioner.
Results: Musculoskeletal non-emergency ED referrals decreased by 40.6% (p < 0.001) after initiation of the OWICs, allowing optimal use of resources to address the COVID-19 surge.
Conclusion: This paper describes the OWIC model and its preliminary impact. The OWICs could serve as a template for other orthopaedic departments during the pandemic.
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http://dx.doi.org/10.1016/j.jor.2020.05.014 | DOI Listing |
PLoS One
August 2024
Orthopedics Unit, Department of Surgery, University of Nairobi, Nairobi, Kenya.
Background: Inappropriate utilization of higher-level health facilities and ineffective management of referral processes in resource-limited settings are becoming increasingly a concern in health care management in developing countries. This is characterized by self-referral and frequent bypassing of the nearest health facilities coupled with low formal referral mechanisms. This scenario lends itself to a situation where uncomplicated medical conditions are unnecessarily managed in a high-cost health facility.
View Article and Find Full Text PDFJ Orthop Case Rep
July 2024
Department of Orthopaedic Surgery, Nagoya City University East Medical Center, Nagoya, Japan.
Introduction: Bilateral posterior fracture-dislocation of the shoulder is a very rare injury that is commonly missed. Almost 70% of bilateral posterior dislocations are due to convulsive seizures, with electric shocks accounting for < 5% of bilateral posterior shoulder dislocations.
Case Report: The case of a walk-in patient, a 52-year-old man, with bilateral posterior fracture-dislocation of the shoulder caused by an electric shock is reported.
Am J Emerg Med
August 2024
Department of Orthopaedic Surgery, The Johns Hopkins Hospital, 601 N Caroline St 5th Floor, Baltimore, MD 21205, USA. Electronic address:
Introduction: The incidence of infection in open tibial shaft injuries varies with the severity of the injury with rates ranging from roughly 2% for Gustilo-Anderson type I to nearly 43% for type IIIB fractures. As with all fractures, timely antibiotics administration in the emergency department (ED) is an essential component of fracture management and infection prevention. This study identifies factors associated with the expedient administration of antibiotics for open tibial shaft fractures.
View Article and Find Full Text PDFActa Vet Scand
June 2024
Department of Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, P.O. Box 7070, Uppsala, SE-75007, Sweden.
Background: Kinetic and kinematic gait analysis is increasingly practised as a part of lameness evaluation in dogs. The aim of this study was to examine the normal short- and long-term variation in forelimb gait in sound control dogs (CD) at a walk using seven selected variables of objective kinetic and kinematic gait analyses. Also, to compare the findings in CD to a group of forelimb lame dogs with elbow osteoarthritis (OAD).
View Article and Find Full Text PDFJMIR Mhealth Uhealth
June 2024
Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai, China.
Background: In emergency departments (EDs), triage nurses are under tremendous daily pressure to rapidly assess the acuity level of patients and log the collected information into computers. With self-service technologies, patients could complete data entry on their own, allowing nurses to focus on higher-order tasks. Kiosks are a popular working example of such self-service technologies; however, placing a sufficient number of unwieldy and fixed machines demands a spatial change in the greeting area and affects pretriage flow.
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