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Volume 104-B, Issue SUPP_1 January 2022 The British Indian Orthopaedic Society (BIOS) Annual Scientific Meeting, Cardiff, Wales, 2–3 July 2021.

Sriram Harish Srinivasan Sanjay Narayana Murthy Amit Jagdish Bishnoi Girish Swamy

Abstract

In the pediatric population, scoliosis is classified into congenital, syndromic, idiopathic, and neuromuscular in aetiology. Syndromic scoliosis represents a wide range of systemic anomalies associated with scoliosis. The primary challenge for a clinician is to think beyond the scoliotic curve, as the underlying pathology is multisystemic. The aim of this review is to identify the systemic anomalies, associated with syndromic scoliosis.

MEDLINE, EMBASE, and CINAHL databases were searched, dating from 1990–2020, relevant to the purpose of our study. Keywords used: “scoliosis”+ “syndrome” + “genetic”. Retrospective, prospective studies were included. Case reports that had fewer than 4 patients were not included.

Delineating 60 articles, we found a total of 41 syndromes to be associated with scoliosis. Thoracic region was the most common level of scoliosis curve, being noted in 28 syndromes. Mental retardation, seizures, and ataxia were the commonly noticed CNS anomalies. VSD, ASD, and TGA were the anomalies associated with CVS; Hypotonia, rib and vertebral malformations were the most identified neuromuscular anomalies; pulmonary hypoplasia, renal agenesis, and strabismus were other associations.

A multidisciplinary approach, involving spinal surgeons, paediatricians, geneticists, anesthesiologists, and allied health professionals, is vital for the best care of patients with syndromic scoliosis.

The location of the scoliotic curve reflects the associated anomalies, as thoracic curvature is more closely linked with cardiac anomalies, while lumbosacral curvature is seen to be often linked with genitourinary anomalies. We hope that this article provides a clear overview of the systemic associations in syndromic scoliosis and thus, facilitates and streamlines the management protocol.


Joseph Boktor Awf Alshahwani Amr El-Bahi Purnajyoti Banerjee2 Sashin Ahuja

Abstract

Background

Cauda equina syndrome (CES) is a rare serious condition that, if missed at initial presentation, can lead to serious disability. Early diagnosis is crucial for a favourable outcome. Few studies included urodynamic test and measurement of post-void residual urine (PVR) as an adjunct screening tool for acute CES before proceeding to MRI scan, yet there are differences in the cut-off point as a threshold volume to be considered as a red flag for doing MRI amongst these studies.

Aim

Meta-analysis and systematic review of literature that included PVR as a predictive tool in CES to identify the reliability of PVR and the optimal numerical value to be considered as red flag.


S.V. Sonanis H.S. Bhende

Abstract

A study was done to test the strength of various configurations of tension band wiring (TBW) and we report clinical results of ‘Horizontal Figure of Eight TBW’ (H – 8 TBW).

In an experimental lab, a model of the fractured patella was mounted on a Nene tensile testing machine and various configurations of TBWs were tested in different positions of Kirschner wires. The strength of TBW and various knots securing the ends of wires were analysed on load/displacement graphs. The experimental results were compared with the theoretical results using trigonometry and mathematical equations. Since 1986, H – 8 TBW (Sonanis and Bhende modification) was used clinically in 42 patients (40 fractured patella, and 2 greater trochanteric osteotomies) in 26 males and 16 females and all patients were followed up to average 18 months.

Experimentally H – 8 TBW (0.8mm wire) could resist maximum distraction force of 700 N and achieved maximum compression. Placement of the two Kirschner wires at the mid way between centre and edge of patella at the level of fracture site achieved optimum rotational stability and compression. Crimping method of gripping the ends of wires was the most secured method (120 N). Clinically bony union using H-8 TBW was achieved in all 41 patients. Complications seen were wire discomfort in 3 patients and one death.

We conclude that H – 8 TBW achieved maximum compression, optimum K wire placement was at the 1/4th distance from the edge of the patella, and crimping the ends of wire secured best fixation.


Gautam Reddy Vishal Rajput Shambu Singh Shoaib Iqbal Sanjeev Anand

Abstract

Background

Fracture dislocation of the knee involves disruption of two or more knee ligaments with associated tibial plateau fracture. If these injuries are not evaluated swiftly, can result in a limb-threatening injury. The aim of this study is to look at the clinical outcomes of a single surgeon case series at a major trauma centre.

Methods

Prospectively collected data was analysed for a 5-year period. Primary outcome measures used were International Knee Documented Committee(IKDC) score and Knee Injury & Osteoarthritis Outcome Score(KOOS). The secondary outcome measures include Tegner activity scale, knee range of movements & complications.


Riaz Mohammed Pranav Shah Alexander Durst Naveen Mathai Alexandru Budu Rikin Trivedi Jibin Francis Julie Woodfield Patrick Statham Tom Marjoram Saaj Kaleel David Cumming Matthew Sewell Alexander Montgomery Ahmed Abdelaal Vinay Jasani Aprajay Golash Sam Buddhiw Kia Rezajooi Robert Lee John Afolayan Roozbeh Shafafy Nikki Shah Thomas Stringfellow Chadi Ali Uche Oduoza Sai Balasubramanian Chaitanya Pannu Sashin Ahuja

Abstract

Aim

With resumption of elective spine surgery services following the first wave of COVID-19 pandemic, we conducted a multi-centre BASS collaborative study to examine the clinical outcomes of surgeries.

Methods

Prospective data was collected from eight spinal centres in the first month of operating following restoration of elective spine surgery following the first wave. Primary outcomes measures were the 30-day mortality rate and postoperative Covid-19 infection rate. Secondary outcomes analysed were the surgical, medical adverse events and length of inpatient stay.


Parag Raval Abbas See Harvinder Singh DTC Collaborative

Abstract

Background

Distal third clavicle (DTC) fractures represent 2.6 to 4% of all adult fractures but there is no consensus as to the surgical management of these injuries. The primary outcomes of this study were to determine the frequency of DTC fractures and their management. Secondary outcomes included complications, further procedures, fracture union and the breakdown of treatment by modified Neer classification.

Methods

A multicentre cohort study was conducted between 1st January 2019–31st December 2019. All patients, over 18 years old, with an isolated DTC fracture were included. Demographic variables, management, mechanism of injury, modified Neer classification and fracture union were recorded. Simple statistical analysis was performed as a total dataset and as a breakdown of major trauma centres (MTCs) vs trauma units (TUs).


Nimesh Nebhani Christopher Ogbuagu Gunasekaran Kumar

Abstract

Background

Atypical femur fracture (AFF) is a well known complication of Bisphosphonate therapy. Due to prolonged suppression of bone re-modelling in these fractures, surgical complications are difficult to manage. The aim of this study was to analyze the causes of surgical complications in AFF fixations and provide algorithm for management.

Method

In this retrospective 10-year study (2010–2020), we identified patients surgically treated for AFF. We included patients who underwent revision surgery for any cause. Data collection included demographics, surgical complications, details of revision surgery and time to union.


Rishi Agarwal Khitish Mohanty

Abstract

Background

Prospective study to compare patient reported outcome measures (PROM) for sacroiliac joint (SIJ) fusion using HA-coated screw (HACS) vs triangular titanium dowel (TTD). First study of its kind in English literature.

Methods

40 patients underwent SIJ stabilisation using HACS and TTD was used in 70 patients at CAVUHB, Cardiff. PROMs were collected prospectively before surgery and 12 months post-op. Short Form (SF)-36, Oswestry Disability Index, EuroQol-5D-5L and Majeed Pelvic Scores were collected. Shapiro-wilk test was used to determine normality of data. Mann-whitney U test was used to compared non-parametric data and Independent sample T test for parametric data.


Shahnawaz Haleem Awaiz Ahmed Satish Ganesan Stephen McGillion John Fowler

Abstract

Objective

Flexible stabilisation has been utilised to maintain spinal mobility in patients with early-stage lumbar spinal stenosis (LSS). Previous literature has not yet established any non-fusion solution as a viable treatment option for patients with severe posterior degeneration of the lumbar spine.

This feasibility study evaluates the mean five-year outcomes of patients treated with the TOPS (Total Posterior Spine System) facet replacement system in the surgical management of lumbar spinal stenosis and degenerative spondylolisthesis.

Methods

Ten patients (2 males, 8 females, mean age 59.6) were enrolled into a non-randomised prospective clinical study. Patients were evaluated with standing AP, lateral, flexion and extension radiographs and MRI scans, back and leg pain visual analog scale (VAS) scores, Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ) and the SF-36 questionnaires, preoperatively, 6 months, one year, two years and latest follow-up at a mean of five years postoperatively (range 55–74 months). Flexion and extension standing lumbar spine radiographs were obtained at 2 years to assess range of motion (ROM) at the stabilised segment.


Anshul Sobti Zahra Jaffry Siddhart Raj Anthony Yiu Ahmed Negida Bijayendra Singh Peter Brennan Mohammed Imam Orthoglobe Collaborative

Abstract

Background

Healthcare workers have had to make rapid and drastic adjustments to their practice in response to the COVID-19 pandemic. This work describes the effect on their physical, mental, financial and family well-being and assesses the support provided by their institutions.

Methods

An online survey was distributed through medical organisations, social media platforms and collaborators to staff based in an operating theatre environment.


Manikandar Srinivas Cheruvu Muthu Ganapathi

Abstract

Background

Conventional TKR aims for neutral mechanical alignment which may result in a smaller lateral distal femoral condyle resection than the implant thickness. We aim to explore the mismatch between implant thickness and bone resection using 3D planning software used for Patient Specific Instrumentation (PSI) TKR.

Methods

This is a retrospective anatomical study from pre-operative MRI 3D models for PSI TKR. Cartilage mapping allowed us to recreate the native anatomy, enabling us to quantify the mismatch between the distal lateral femoral condyle resection and the implant thickness.


Philip Belcher Kartik P. Iyengar William Y. C. Loh Efe Uwadiae

Introduction

Wide Awake Local Anaesthetic No Tourniquet (WALANT) is a well- established day case procedure for carpal tunnel release with several advantages and enhanced post-operative recovery. Use of Local anaesthesia with Adrenaline using a 27G needle allows a bloodless field and distraction techniques achieve patient comfort during the procedure.

Objectives

This retrospective, observational cohort study assesses patient satisfaction and undertakes functional evaluation using the validated Boston Carpal Tunnel Questionnaire (BCTQ) following WALANT technique for carpal tunnel release (CTR). The BCTQ has a symptom severity scale based on 11 items and a functional status scale of 8 elements. Further we compare surgical outcomes between techniques of WALANT and traditional CTR.


Chiranjit De Saumil Shah Kusy Suleiman Zehong Chen Vishal Paringe Divya Prakash

Abstract

Background

During COVID-19 pandemic, there has been worldwide cancellation of elective surgeries to protect patients from nosocomial transmission and peri-operative complications. With unfolding situation, there is definite need for exit strategy to reinstate elective services. Therefore, more literature evidence supporting exit plan to elective surgical services is imperative to adopt a safe working principle. This study aims to provide evidence for safe elective surgical practice during pandemic.

Methods

This single centre, prospective, observational study included adult patients who were admitted and underwent elective surgical procedures in the trust's COVID-Free environment at Birmingham Treatment Centre between 19th May and 14th July’2020. Data collected on demographic parameters, peri-operative variables, surgical specialities, COVID-19 RT-PCR testing results, post-operative complications and mortality. The study also highlighted the protocols it followed for the elective services during pandemic.


Neil Chotai Dylan Green Abdulkarim Zurgani David Boardman Tobias Baring

Abstract

Aim

The aim of this study was to present the results of treatment of displaced lateral clavicle fractures by an arthroscopically inserted tightrope device (‘Dogbone’, Arthrex).

Methods

We performed a retrospective series of our patients treated with this technique between 2015 and 2019. Patients were identified using the ‘CRS Millennium’ software package and operation notes/clinic letters were analysed. We performed an Oxford Shoulder Score (OSS) on all the patients at final follow-up. Our electronic ‘PACS’ system was used to evaluate union in the post-operative radiographs.


Keith Behram Tamboowalla Viraj Gandbhir Hajime Nagai Henry Wynn-Jones Sumedh Talwalker Peter Kay

Abstract

Background

The COVID-19 pandemic has strongly impacted elective orthopaedic surgery. At our trust, a geographically discrete elective site deals with planned orthopaedic surgery. There was a need to define a green pathway to deliver surgical care safely and efficiently, and tackle mounting waiting lists.

Methods

Records of patients operated at our elective site, between 1st July 2020 and 14th January 2021, under a green pathway, including pre-operative self-isolation, COVID screening and segregating perioperative patients, were reviewed, and analysed retrospectively. Patients who did not attend (DNA) their post-operative follow-up appointments were identified. Finally, regional COVID incidence was compared with that in our centre.


Sriram Harish Srinivasan Sanjay Narayana Murthy George JM Hourston Girish Swamy

Abstract

Non-operative management of AIS can present practical and psychological challenges, as effective bracing requires a considerable investment of time in adolescence which is a formative point of physical and emotional development. The management team lacks input from the psychological team and thus, it would be prudent for the spinal teams to appreciate and deal with the psychosocial effects associated with bracing.

We sought to investigate how bracing as a part of non-operative management of idiopathic scoliosis, is perceived among adolescents.

We performed a search of CINAHL, Medline, AMED, PsychARTICLES, Psychology and Behavioral Sciences Collection and PsychINFO databases to identify qualitative research investigating the thoughts, feelings and experiences and attitudes of those undergoing bracing for AIS. Keywords used were (((“adoles∗” OR “young pe∗”) AND “idiopathic scoliosis”) AND “brac∗”) AND (“perce∗” OR “experience∗” OR “perspective∗” OR “attitude∗”).

Ten research articles were identified using our search strategy. Only one article addressed our research question specifically. This reported that almost all adolescent patients experienced psychological difficulties during treatment and received most of their support from family and friends rather than health professionals.

Our interpretation of the literature on this subject has yielded three recommendations for service providers. First, the policy ought to change to ensure that psycholological support is engrained within the treatment process; second, more information and advice must be given to patients and their families; and third, health professionals should appreciate and directly address in their consultations the psychological difficulties involved in brace wearing and the need for adequate support.


Terin Thomas Shoaib Khan Sanchez J Ballester

Abstract

Objectives

The study aims to determine whether an arthroscopic ligament reconstruction is necessary to relieve clinical ankle instability symptoms in patients with an MRI scan showing medial or lateral ligament tear.

Methods

This was a single centre retrospective case series study of 25 patients with ankle instability and ligament tear on MRI scan who had undergone arthroscopic procedures from January 2015 to December 2018. Patients were followed up for an average period of 3 years postoperatively to check for any recurrence of symptoms


Anil Singhal Ullas Jayaraju Komal Kaur Glen Clewer

Abstract

Background

With the increasingly accepted method of suprapatellar tibial nailing for tibial shaft fractures, we aimed to compare intraoperative and postoperative outcomes of infrapatellar (IP) vs suprapatellar (SP) tibial nails.

Methods

A retrospective cohort analysis of 58 patients. 34 SP tibial nails over 3 years versus 24 IP tibial nails over a similar time frame. We compared; radiation exposure, patient positioning time (PPT), non-union rate and follow-up time. Knee pain in the SP group was evaluated, utilising the Hospital for Special Surgery (HSS) Knee injury and Osteoarthritis outcome score (KOOS).


Amit Bishnoi Martin Hughes Steven Godsiff

Abstract

Background

The use of tourniquet in knee arthroplasty is common but in recent times, it has initiated a debate on its use. Complications from use of tourniquet are well documented in literature but there is less evidence on thigh pain, blood loss and length of stay post arthroplasty.

Methods

We included 62 patients undergoing knee arthroplasty either Unicondylar knee arthroplasty or total knee arthroplasty. Patients were allocated randomly in tourniquet and without tourniquet groups. Half of the patients had UKA and other half TKA. Thigh pain was recorded using Visual analogue scale on day 1, 2 and on discharge. A drop in pre-operative and post operative haemoglobin level was recorded too. Independent sample t-test was done to compare the difference between the 2 groups mainly, drop in haemoglobin, thigh pain, knee pain and length of stay.


R. Kattimani A. Denning F. Syed

Abstract

Background

The European population is consistently getting older and this trend is expected to continue with fastest rise seen in those over 85 years old. As a consequence there will be more nonagenarians (over 90 years old) having lower limb arthroplasty.

Objectives

To compare the length of stay, readmission and one year mortality between nonagenarians and people aged between 70 to 80 years after having lower limb arthroplasty.


Milind Mehta Aditya Soni Sandeep Munshi Gautam Talawadekar

Abstract

Introduction

Clinic letters to the general practitioner (GP) form an essential part of communication in a patient's care. One essential variable requiring 100% compliance is the laterality/side of the diagnosis. Rationale of this audit was to check compliance of the same in clinic letters, to implement changes within the department initially followed by trust wide change in policy to improve the same.

Material and Methods

Clinic letters over a period of time were read through in retrospect to see for mention of side. The exclusion criteria were COVID consenting letters over phone, “did not attend” letters and letters for spinal pathology.

After 1st limb of audit following actions were taken: doctor education, secretaries to remind the dictating doctor to mention side in the letter and putting up of laminated prompters in all T&O clinic rooms to remind doctors. Following this a 2nd limb was conducted with similar parameters.


Rajib Naskar Laura Oliver Patricia Velazquez-Ruta Baljinder Dhinsa

Abstract

Objectives

This study aims to evaluate the functional outcomes of early weight-bearing in a functional orthosis for conservatively managed, complete AT ruptures. Also we tried to evaluate the patient reported outcome with this form of treatment.

Design

In this prospective study, we have analysed data from 41 patients with ultrasound diagnosed compete AT ruptures, with a gap of less than 5 cm. Every patient was treated in a functional weight-bearing orthosis (VACOped®) for 8 weeks with early weight-bearing following a specific treatment protocol, followed by rehabilitation with a trained physiotherapist.


Rahul Mohan Terin Thomas Tariq Kwaees Ravi Pydisetty

Abstract

Background

The gold standard treatment for Anterior Cruciate Ligament injury is reconstruction (ACL-R). Graft augmentation with suture tape (internal brace) are techniques purported to reduce the risk of rupture and hasten recovery. Our aim was to assess the short-term outcome of ACL-R using fibre tape augmented and non-augmented hamstring tendon grafts.

Methods

This was a retrospective comparative study looking at augmented and non-augmented ACL-R. All procedures were performed by a single surgeon in a single centre using the same technique. The Knee injury and Osteoarthritis Outcome Score [KOOS] was used to assess patient-reported outcomes.


Mohammed Shaeir Marjan Raad Susan Graham Raj Shrivastava

Abstract

Background

Blood transfusion requirement after primary total hip replacements (THR) and total knee replacements (TKR) was found to be related to increased post-operative complications rate and length of hospital stay. Pre-operative haemoglobin level remains the single most important factor determining the requirement for post-operative blood transfusion.

Methods

We carried out a local retrospective audit of 977 THRs and TKRs in 2019. Pre-operative and pre-transfusion haemoglobin levels for transfused group of patients were recorded.


Joseph Boktor Abdul Badurudeen Ahmed Alsayyad Wahid Abdul Sashin Ahuja

Abstract

Background

University Hospital of Wales (UHW) went live as a Major Trauma Centre (MTC) on the 14th September 2020. New guidelines have been set up by the Wales Trauma Network.

Aim

Prospective audit to see how many admissions, correct pathways were followed?


Oliver Brown Andrew Gaukroger Toby Smith Prodromos Tsinaslanidis Caroline Hing

Abstract

Background

Alcohol has been associated with up to 40% trauma-related deaths globally. In response to the Covid-19 pandemic, the United Kingdom (UK) entered a state of ‘lockdown’ on 23rd March 2020. Restrictions were most significantly eased on 1st June 2020, when shops and schools re-opened. This study aimed to quantify the effect of lockdown on trauma admissions specifically regarding alcohol-related trauma.

Methods

All adult patients admitted as ‘trauma calls’ to a London Major Trauma Centre (MTC) during April 2018 and April 2019 (pre-lockdown; N=316), and 1st April – 31st May 2020 (lockdown; N=191) had electronic patient records (EPR) analysed. Patients’ blood alcohol level (BAC) combined with records of intoxication were used to identify alcohol-related trauma. Multiple regression analyses were performed to compare pre- and post-lockdown alcohol-related trauma admissions.


Chiranjit De Nimrath Kainth Pratap Harbham Margaret Brooks Sujit Agarwal

Abstract

Background

This study aims to estimate the risk of acquiring a medical complication or death from COVID-19 infection in patients who were admitted for orthopaedic trauma surgery during the peak and plateau of pandemic. Unlike other recently published studies, where patient-cohort includes a more morbid group and cancer surgeries, we report on a group more akin to those having routine elective orthopaedic surgery.

Methods

The study included 214 patients who underwent orthopaedic trauma surgeries in the hospital between 12th March and 12th May 2020 when the COVID-19 pandemic was on the rise in the United Kingdom. Data was collected on demographic profile including comorbidities, ASA grade, COVID-19 test results, type of procedures and any readmissions, complications or mortality due to COVID-19.


D. V. Sree K. P. Iyengar D. Loh S. Shrestha W. Y. C. Loh

Abstract

Background

Scaphoid non-union can result in pain, altered wrist kinematics leading to a Scaphoid Non-union Advance Collapse, ultimately to symptomatic radio-carpal arthritis. Open techniques have their limitations. We describe the rationale, surgical technique and outcomes of our series of arthroscopic bone-grafting (ABG) and fixation of scaphoid non-union.

Methods

We performed a prospective single-surgeon series of 22 consecutive patients with clinico-radiologically established scaphoid non-union between March 2015 and April 2019. Data was collected from Electronic Patient Records, Patient Archived Computer system (PACS) and hand therapy assessments. We collected demographic data including age, hand-dominance, occupation and mechanism of injury. The Disabilities of the Arm, Shoulder and Hand Score (Quick DASH), Mayo wrist score, Patient Rated Wrist Evaluation (PRWE) and grip-strength measurements were collected preoperatively and at follow-up appointments.


M. Awadallah J. Ong N. Kumar P. Rajata M. Parker

Abstract

Background

Dislocation of a hip hemiarthroplasty is a devastating complication with a high mortality rate in elderly patients. Previous studies have suggested a higher dislocation rate in patients with neuromuscular conditions. In this study, we have reviewed our larger cohort of patients to identify whether there is any association between neuromuscular disorders and prosthetic dislocation in patients treated with hip hemiarthroplasty for femoral neck fractures.

Patients and Methods

Our study is a retrospective analysis of data collected over 34 years for patients with intracapsular neck of femur fracture who underwent hip hemiarthroplasty. The study population is composed of four groups: patients with no neuromuscular disorders, patients with Parkinson's disease, patients with previous stroke, and patients with dementia.


Vishal Rajput Gautam Reddy Shoaib Iqbal Shambhu Singh Mohammad Salim Sanjeev Anand

Abstract

Background

Traumatic knee dislocations are devastating injuries and there is no single best accepted treatment. Treatment needs to be customised to the patient taking into consideration injury to the knee; associated neurovascular and systemic injuries.

Objective

This study looked at functional outcome of a single surgeon case series of patients who underwent surgical management of their knee dislocation.


Shahnawaz Haleem Muzaffar Malik Venu Guduri Christine Azzopardi Steven James Rajesh Botchu

Abstract

Purpose

No clinical CT based classification system is currently in use for Lumbar Foraminal Stenosis. MRI scanners are not easily available, are expensive and may be contraindicated in an increasing number of patients. This study aims to propose and evaluate the reproducibility of a novel CT based classification for lumbar foraminal stenosis.

Materials and Methods

The grading was developed as 4 grades. Normal foramen – Grade 0, Anteroposterior(AP)/Superoinferior (SI)(single plane) fat compression – Grade 1, Both AP/SI compression (two planes) – Grade 2 (both AP and SI) without distortion of nerve root, Grade 2 with distortion of nerve root – Grade 3.

800 lumbar foramen of a cohort of 100 random patients over the age of 60 who had undergone both CT and MRI scans were reviewed by two radiologists independently to assess agreement of the novel CT classification against the MRI based grading system of Lee et al. Interobserver(n=400) and intraobserver agreement(n=160) was also evaluated. Agreement analysis was performed using the Weighted Kappa statistic.


Anshul Sobti Anthony Yiu Zahra Jaffry Mohammed Imam

Abstract

Introduction

Minimising postoperative complications and mortality in COVID-19 patients who were undergoing trauma and orthopaedic surgeries is an international priority. Aim was to develop a predictive nomogram for 30-day morbidity/mortality of COVID-19 infection in patients who underwent orthopaedic and trauma surgery during the coronavirus pandemic in the UK in 2020 compared to a similar period in 2019. Secondary objective was to compare between patients with positive PCR test and those with negative test.

Methods

Retrospective multi-center study including 50 hospitals. Patients with suspicion of SARS-CoV-2 infection who had underwent orthopaedic or trauma surgery for any indication during the 2020 pandemic were enrolled in the study (2525 patients). We analysed cases performed on orthopaedic and trauma operative lists in 2019 for comparison (4417). Multivariable Logistic Regression analysis was performed to assess the possible predictors of a fatal outcome. A nomogram was developed with the possible predictors and total point were calculated.