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How Has COVID-19 Changed the Way Orthopaedists Take Care of Patients?

AN ORTHO-PINION
Julie B Samora, MD

Julie B. Samora, MD, MPH, PhD., FAAOS

Any views or recommendations shared in the Ortho-pinions blog are solely those of the authors and do not necessarily represent those of the American Academy of Orthopaedic Surgeons. 

COVID-19 has affected all aspects of healthcare, including musculoskeletal care. Although orthopaedic surgeons continue to provide excellent care for their patients, almost all elective surgeries have been postponed or cancelled, and many non-urgent visits are being delayed. Much of musculoskeletal care is now focused on treating urgent/emergent injuries and determining ways to evaluate and treat non-urgent issues in the safest manner possible.

The pandemic has quickly ushered in the use of more telehealth options, such as performing non-urgent evaluations and post-operative visits through electronic means, rather than in person. Visits are being conducted by video or, for those patients who do not have access to video, by phone. This immediate demand for telemedicine has expedited a process that would have, otherwise, taken much longer to implement on such a global scale. This is actually one positive outcome of the pandemic. 

We are also collaborating with our therapy colleagues in different ways to determine the best treatment options for our shared patients. The ability to participate in physical therapy remotely—while waiting for surgery or rehabilitating from an injury—is yet another way to address patients’ musculoskeletal needs while maintaining safe social distancing.

For pediatric patients, scoliosis surgeries and other elective cases are being postponed. COVID-19 has played a role in the decision-making process for how acute pediatric injuries are being treated. When accounting for the risk/benefit ratio of proceeding with surgery for an acute fracture in the era of COVID-19, there has been a pendulum swing toward nonoperative care for many injuries. For example, some types of elbow fractures (supracondylar humerus type II fractures) that have commonly been treated with surgery in the past are now being treated with a cast to prevent further exposure for patients and their families, as well as to save needed PPE. We have also transitioned to treating some fractures with braces and removable splints—instead of casts— to save families from making yet another in-person visit.

Orthopaedic surgeons are also creating new handouts for pediatric patients and their parents with post-injury care instructions and exercises to work on at home, in order to minimize exposure during in-person therapy sessions. Telemedicine has played a tremendous role in the care of young patients, as well, enabling pediatric providers to evaluate non-urgent issues and provide reassurance to families that any delay in surgery or care will not affect overall outcomes.

Read more: Elbow Fractures in Children

Last Reviewed

April 2020

Contributed and/or Updated by

Julie B. Samora, MD, MPH, PhD., FAAOS

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.