key: cord-0886037-rsg198ym
authors: Vigliaroloa, D.
title: COVID-19 and hand surgery: the perspective of an Italian hand therapist
date: 2020-12-10
journal: Hand Surg Rehabil
DOI: 10.1016/j.hansur.2020.11.006
sha: ca9ba61f5229da30a7e0659f804da200790529ea
doc_id: 886037
cord_uid: rsg198ym

nan

had suffered. Unfortunately, they preferred to self-medicate because they were afraid of going to the hospital. As a consequence, we treated fractures and flexor tendon injuries with considerable delay. Moreover, many patients did not follow the physiotherapy programs because of the lockdown of physiotherapy centers and the fear of going in crowded places. Thus, we observed worse postoperative outcomes, with the need to re-operate on some patients because of the occurrence of tendon adhesions.

The management of patients suffering from chronic diseases remains inadequate. The waiting list is always long, and it will only get longer as the pandemic gets worse. Patients suffering from Dupuytren's contracture ask for collagenase injections as outpatients, given the good results we obtained in the past [4] . Unfortunately, this drug is no longer available in Europe and there is no suitable physiotherapy protocol to prevent progression of the disease [5] . Patients suffering from osteoarthritis or neuropathic pain (e.g. carpal tunnel syndrome) postpone scheduled surgery and sometimes prefer symptomatic treatment but do not follow physiotherapy protocols for fear of being in closed rooms with other patients [6, 7] .

Given this history and the recent growth of the pandemic, are we ready for a "second wave"?

Is it possible to improve health care in the field of hand surgery and rehabilitation?

When it comes to hand trauma cases, we need to avoid what occurred in the first wave. We must try to ensure access to care for all patients. In the short term, hand surgery and hand rehabilitation are essential care that should not be overlooked. Safe and prompt access routes to hand surgery departments are necessary for patients suffering from hand injuries. Adequate number of operating rooms should be allocated, and physiotherapy services should be supported no less than hand surgery departments. Physiotherapy departments should be exempt from the lockdown.

How hand and wrist trauma has changed during covid-19 emergency in Italy: Incidence and distribution of acute injuries. What to learn?

COVID-19: Initial experience of an international group of hand surgeons

Spinal surgery in COVID-19 pandemic era: One trauma hub center experience in central-southern Italy

Seven -year clinical outcomes after collagenase injection in patients with Dupuytren's disease: A prospective study

Xiapex TM will no longer be distributed in Europe: Our concerns and our hopes relative to collagenase

The use of alfa-lipoic acid-R (ALA-R) in patients with mild-moderate carpal tunnel syndrome: A randomised controlled open label prospective study

Endorsement by Central European experts of the revised ESCEO algorithm for the management of knee osteoarthritis

COVID-19 contagion and contamination through hands of trauma patients: what risks and what pr ecautions?

Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents

Global telemedicine implementation and integration within health systems to fight the COVID-19 pandemic: A call to action