Volumen 3 (2020): Edición 2 (December 2020)

The mechanism of mesenteric injury in blunt abdominal trauma involves compression and deceleration forces which result in a spectrum of injuries that range from contusions to tearing of the bowel wall, tearing of the mesentery, and loss of vascular supply. Hemoperitoneum is a major sign of severity in abdominal trauma, which, in most cases, requires emergency surgery.

Our patient showed that the diagnosis of mesenteric injury should be considered even in patients who sustain only minor abdominal trauma. In this case the patient’s symptoms were suggestive only for the orthopedic lesion and not for the hemoperitoneum.

Trans-scapho-lunate dislocation fracture is a rare lesion that may go unnoticed at initial assessment in a polytraumatized patient. A delay in the diagnosis and treatment of a scaphoid fracture may alter the prognosis after consolidation.

The liver is one of the most affected organs in abdominal trauma mostly because of its considerable dimensions, the fragility of the liver parenchyma.

We present the case of a 29-year-old patient who sustained an abdominal trauma after an accidental fall from a 3 m height. The patient tested positive at RT-PCR for SARS-CoV-2 at admission, without any symptoms of viral infection. The emergency CT scan revealed a blunt liver trauma with an expanding hematoma (grade III). The patient was initially hemodynamically stable but shortly after admission became unstable and required surgical treatment that initially consisted of damage control and liver packing. Reintervention was decided 36 hours later, after reevaluation unpacking and hepatorrhaphy were done. The postoperative evolution was uneventful. The case indicated the importance of continuous monitoring of the traumatic patient. In liver trauma, hemodynamic instability guarantees an emergency laparotomy. The time of operations in trauma patients with SARS-CoV-2 must be reduced to the maximum both as an objective of damage control and also to minimize the risk of contagion.

The current socio-economic development has improved the standard of living of the general population. Technological evolution has led to the use of an increasing number of motor vehicles. Associated with the growing violence observed globally, orthopedic surgery involves frequent use of osteosynthesis materials and prostheses. Therefore, an increasing number of patients live with these implants, having a higher risk, compared to the general population, to develop complications. Although technological developments have increased the quality of life, it must not be forgotten that these foreign materials come with certain risks, the most feared being the associated infections.

We conducted an epidemiological study on infections identified in patients treated in the Orthopedics and Traumatology Department of Bucharest Emergency University Hospital, from 01.01.2016 to 01.06.2019. We were able to extract data about patients without neglecting their confidentiality.

The information sought, primarily involved the pathogen causing the infection, but at the same time we tried to build a more accurate history of each patient in order to determine the cause of infection and the risks posed by various associated pathologies. During these 4 years we were able to identify 139 patients who suffered an infection in the musculoskeletal system. In most cases we identified mono-microbial infections, but there were 7 cases in which two pathogens were identified.

Introduction: Hospital admissions fell dramatically in Romania during the COVID-19 pandemic partially due to urgent legislation for controlling the infection rates that influenced the selection criteria for hospitalization and also due to fear of infection with SARS-CoV-2 which resulted in avoiding medical services.

Aim: This study aimed to assess the impact of COVID-19 pandemic on the population availability to access medical services by comparing the admission rates for all departments of the University Emergency Hospital, Bucharest, from March to August 2019 and March to August 2020.

Methods: A cohort of 38.730 patients was analyzed according to hospitalization rate from March to August 2019 and March to August 2020.

Results: From March to August 2020 patients were hospitalized as a result of a medical emergency rather than an appointment, as outpatient and hospitalization rates changed dramatically. Thus, 67.4% accessed hospitalization from March to August 2019 and 32.6% accessed hospitalization from March to August 2020. The proportion of the patients admitted from the Ambulatory Care Unit decreased significantly from 44.2% in 2019 to 32.7% in 2020. Also, the structure of the patients’ profile has been affected.

Discussion: The COVID-19 pandemic period in 2020 (March-September) affected the hospitalization rate and the structure of the patients’ profile that came to the University Emergency Hospital in Bucharest, Romania.

Conclusion: The patients who would have accessed the medical health services that might have resulted in hospitalization could have resulted in out-of-hospital deaths and this should also be the focus of the public health authorities.

Introduction: The study weighs the impact of accidents involving electric scooters and motorcycles, its main purpose being that of showing the injuries produced by the use of electric scooters.

Materials and method: The retrospective study was conducted in the Emergency Unit of the University Emergency Hospital Bucharest, Romania, between 01.06.2020 and 30.09.2020, by analyzing the data from the presentation sheets and the hospital database. It followed and compared a total of 55 cases, out of which 29 patients were involved in motorcycle accidents, and 26 patients were involved in electric scooter accidents, by number, age, sex, imaging investigations, severity of injuries, hospitalization days, and the treatment of discharged patients.

General data about the number of analyzed presentations was extracted and compared to similar data from the same period of the year 2019.

Results: The study showed an increase in presentations due to electric scooter accidents. Also, most of the injuries in both types of accidents are musculoskeletal (96.5% in motorcycle accidents and 84.61% in electric scooter accidents), and the percentage of discharged patients who needed immobilization by various orthopedic devices was higher in electric scooter accidents (34.8%) than in motorcycle accidents (26%).

Discussions: The study was conducted in the middle of the COVID-19 pandemic, in an atypical situation, due to regulations imposed by the authorities.

Conclusion: There was an increase in the use of electric scooters in the summer of 2020, which resulted in an increased number of mainly orthopedic injuries, and implicitly of immobilization for discharged patients, underestimated by the population, as protective equipment is not mandatory for people aged over 16 years.