Orthopaedic Practice During COVID-19 Outbreak - SGT Hospital Gurugram

The medical college witnessed a fair number of emergencies in this period. When a patient comes, we are not sure whether he is COVID Negative or Suspected positive or a COVID Positive patient. In all probabilities we assume that the patient is COVID Positive or at least suspected COVID Positive; we have to take precautions. The orthopaedic emergencies can be in the form of fractures which can be open or closed. We formulated certain policies, that as far as this outbreak is concerning, we must treat all closed fractures conservatively. We must make the patient comfortable with either splints or a plaster, wideout them in the ward and as soon as he improves or his status becomes negative; then we can plan surgery taking again all precautions in the operation theatre because there is paramedical staff, operating team, anaesthesia team, everybody is involved & there is a probability of aerosols coming out. Thus, all these fracture cases we thought of treating conservatively. Open fractures, of course, we have to apply external fixators. Whenever we are required to go to COVID Ward, our team of doctors wear the PPE Kit. My advice to them is on two lines: Corona is invisible but we are not Invisible. There is a fear in the mind, fear is okay but for that fear, we have to take precautions. Yesterday only we got two cases, the policy during this outbreak is that we would like to manage these cases conservatively.
Scenario

Sir, Emergency mein ek patient aaya hai. This is the X-Ray of the patient and sir the patient is COVID Positive. COVID Positive? Yes Sir. Kahan se aaya hai? A patient has referred from an outside hospital and there is a history of fall from stairs. Closed hai ya Open Wound hai? Sir Closed Fracture hai. Dekho aisa hai, COVID Positive hai? Ji Sir. So, as per our policy, we will try to manage this patient in a closed way. Abhi usko sirf plaster lagayenge so that he is comfortable, Splinting ho jayegi. Analgesic denge. Keep him admitted. Jab COVID Negative ho jayega , I think we’ll have to do nailing on this.

He is Pramod, aged 18 years who is admitted in this hospital as COVID positive patient sustained a fracture of his Left Leg. Our team of doctors has arrived, they are now applying plaster on this patient, that is the treatment we have decided on this patient. First stockinet has been put, now the soft roll is being applied. His X-ray has been taken with a portable X-Ray machine in the department. They are applying a slab now. This is the modality of treatment in such outbreaks and the moment he turns negative, we would like to operate on this patient.

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