Table 1. Recommended management of traumatic injuries during COVID-19 pandemic .
1 Non-absolute indication for admission (non-life- and limb-threatening injuries); admit if urgent surgery is planned otherwise discharge and plan for day surgery
2 No indication for admission: to be managed in the ED and followed in the outpatient clinic
3 To facilitate prompt treatment, especially in the absence of qualified surgeons, hemiarthroplasty may be the best treatment option for the majority of patients with sub-capital hip fractures
| Absolute Indication for admission | Relative Indication for admission1 | Contraindication to admission2 |
| Polytrauma patients | Peri-articular fractures | Stable upper/ lower limb fractures +/- minimal displacement |
| Pelvic & acetabular fractures | Intra-articular fractures | Stable spinal fractures |
| Spinal fractures with instability and /or neurologic impairment | Lower limb: knee, tibial, foot & ankle injuries | Dislocations of native and replaced joints with acceptable reductions |
| Pathological fractures due to primary/metastatic bone disease | Upper limb injuries needing surgery as forearm, wrist or proximal humeral fractures | Upper limb fractures (clavicle, humeral, wrist) with high union rates |
| Musculoskeletal injuries with associated vascular or neurological morbidity | Non-unions which threaten the soft-tissue envelope | Non-contaminated penetrating limb injuries with no neurological or vascular deficit |
| Prosthetic joint infections or infected fracture fixation with life-threatening uncontrollable sepsis | Ligamentous injuries of the knee and the elbow requiring operative treatment | Abscesses in patients without systemic sepsis |
| Septic arthritis/ systemic sepsis | ||
| Cauda equina syndrome | ||
| Compartment syndromes | ||
| Open fractures | ||
| Hip fractures3 | ||
| Femoral fractures | ||
| Irreducible joint dislocation |