New management and trauma incidence in hand surgery during the phase 1 of COVID-19 pandemic in a referral hand surgery and microsurgery center into the outbreak in North Italy

BACKGROUND: This is a retrospective study of the casuistry occurred at the Hand Surgery and Microsurgery HUB Center of Emilia-Romagna during the months of March and April 2020 in the peak of Phase 1 of COVID-19 pandemic in Italy, comparing the data with the same period in 2019.METHODS: A more relevant reduction of 92.3% in elective surgery and a significantly less relevant reduction of 37.2% in emergencies was recorded. Replantation did not present reduction while cutting lesions of tendons and saw injuries increased such as the injuries during domestic activities.RESULTS: The incidence of hand trauma looks not only at the traditional field of artisanal and industrial injuries, but also to the most recorded accidents in daily life activities. The data evidenced the significantly increase of the injuries occurring in the domestic environment. The 72.8% of emergencies was treated in day-service with significantly reduction in hospitalization, costs and infective risks. Telemedicine implementation has experienced to upgrade the relationship in the emergency network.CONCLUSIONS: Hand injuries remained a major issue also during the lockdown. A functional and skill emergency service and day-service during the phase 1 COVID-19 pandemic played a relevant role in efficacy and efficiency. The utility of telemedicine was greatly limited by liability and risk management issues.