How does COVID-19 impact hand and upper extremity treatment?

The COVID-19 pandemic has dramatically affected all facets of the practice of healthcare. In order to fulfill the public health objectives of stopping the spread of the virus and preserving vital resources such as hospital beds, ventilators, and personal protective equipment, all surgical specialties, including hand surgery, have made drastic changes to daily practice. 

Curtailed clinic schedule

Dr. Carlo is continuing to see patients in clinic. However, patients are encouraged to evaluate the severity of their conditions and schedule or reschedule their in-office visits appropriately to minimize risk of spread of the virus. Telemedicine visits, discussed below, are options for most patients. Any patient with at-risk travel history or symptoms including fever, cough, malaise, will need to reschedule and seek appropriate care.   

Embracing Telemedicine

The coronavirus pandemic has brought the necessity and convenience of telemedicine visits into the forefront.  Telemedicine connects health care providers to patients via telephone or video connection. This clinic is happy to offer telemedicine visits as an option for patients. 

As a result of the COVID-19 pandemic, insurances now accept a wide variety of telemedicine visits. Patients approved for telemedicine visits include:

  • Any new patient
  • Any established patient
  • Any postoperative patient

Telemedicine is ideal for patients who:

  • Wish to maintain social distancing
  • Have simpler or non-urgent conditions amenable to a video consultation
  • Need follow-up of certain postoperative conditions.

When scheduling appointments, indicate your wish to conduct the visit over telemedicine. Shortly before your appointment, you will receive a text or email with a link. Simply clicking the link will open the telemedicine website, where your visit will soon occur. 

Dr. Carlo doing a telemedicine appointment with a patient.

Delaying elective surgeries

In order to mitigate the spread of COVID-19 and preserve healthcare resources, the Centers for Medicare and Medicaid Services (CMS), the American College of Surgeons (ACS), and the U.S. Surgeon General have recommended delaying elective surgical procedures.  

An elective surgery is one where an expected delay in time would not lead to a worse outcome, or would not cause undue suffering. The field of orthopedics and hand surgery is comprised of a large  number of elective surgeries.  Several of these conditions can be managed successfully on a temporary basis with medication, injections, or splinting.  

Elective surgeries for which rescheduling is recommended include:

  • Carpal tunnel syndrome
  • Trigger finger 
  • De Quervain’s tendonitis
  • Surgery for arthritis 

Certain conditions are not appropriate for delayed care. These include:

  • Acute nerve or tendon lacerations
  • Open fractures
  • Closed fractures that require surgery
  • Acute infections
  • Compartment syndromes

The decision to perform or delay a certain surgery requires an in-depth evaluation of the patient and the condition. Many conditions can be treated successfully or temporized with conservative management, so if you are uncertain whether to make a visit or whether our conditions merits surgery, please do not hesitate to contact the clinic. 

Dr. Carlo’s goal, as always, is to take the best care of every patient. During the COVID-19 pandemic, this includes following a moral obligation to protect patients and the public from unnecessary risk while never neglecting any patient who needs urgent care or surgery.

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