The impact of COVID-19 prevention measures on epidemiology of orthopedic injuries: the outbreak ages fractures! Epidemiologic changes of fractures during COVID-19 outbreak.

Main Article Content

Giuseppe Gianluca Costa
Giuseppe Fanzone
Angelo Graceffa
Michele Lauria
Gianluca Zocco
Antonino Cassarà
Alberto Campailla
Alessia Saccà
Enrico Santanna
Gianclaudio Caputo
Arcangelo Russo

Keywords

COVID-19, fractures, epidemiology, age.

Abstract

Background: The application of stringent prevention measures for contrasting COVID-19 spread generated changes not only in the outbreak course, but also in epidemiology of traumatic fractures. The aim of this study was to report the epidemiologic characteristics of surgically-treated fractures during the COVID-19 outbreak over a six-month period, and to describe the variation in volumes and types of injuries, by comparing them with fractures which occurred during the same period in 2019.


Methods: We retrospectively analyzed all surgically-treated fractures which were admitted from the January 1st 2020 to June 30th 2020, and compared these data to those of the corresponding timeframe in 2019. The collected data of interest included demographics, such as age and gender, fracture location, time lapse between presentation at Emergency Department and admission in the ward, length of stay.


Results: A total of 117 patients were admitted with a diagnosis of facture and surgically treated, with no cases of COVID-19 positive patients. In the corresponding period of 2019, the number of patients admitted for the same reasons was 129. This decrease was more significant in the period between March and April (-30.6%), during which time prevention measures were more stringent. The only statistically significant discrepancy between the two study groups was the mean age, which was significantly higher in 2020. The location of examined injuries were similar in the two study groups, with proximal femur fractures representing the most frequent injuries.


Conclusions: This study demonstrated significant changes of epidemiologic patterns of fractures during COVID-19 outbreak. These data should provide support for clinicians and government to evaluate the management and prevention strategies of traumatic not only during outbreak but also in non-outbreak period.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...
Abstract 1 |

References

1. World Health Organization Coronavirus Disease (COVID-19) Dashboard. https://covid19.who.int. Accessed on 7/13/2020.
2. Sarac NJ, Sarac BA, Schoenbrunner AR, et al. A Review of State Guidelines for Elective Orthopaedic Procedures During the COVID-19 Outbreak. J Bone Joint Surg Am. 2020;102(11):942-945.
3. Hernigou J, Morel X, Callewier A, Bath O, Hernigou P. Staying home during "COVID-19" decreased fractures, but trauma did not quarantine in one hundred and twelve adults and twenty eight children and the "tsunami of recommendations" could not lockdown twelve elective operations. Int Orthop 2020;1-8.
4. Zhu Y, Chen W, Xin X, et al. Epidemiologic characteristics of traumatic fractures in elderly patients during the outbreak of coronavirus disease 2019 in China. Int Orthop 2020;1-6.
5. Mi B, Chen L, Xiong Y, Xue H, Zhou W, Liu G. Characteristics and Early Prognosis of COVID-19 Infection in Fracture Patients. J Bone Joint Surg Am 2020;102(9):750-758.
6. Muñoz Vives JM, Jornet-Gibert M, Cámara-Cabrera J, et al. Mortality Rates of Patients with Proximal Femoral Fracture in a Worldwide Pandemic: Preliminary Results of the Spanish HIP-COVID Observational Study. J Bone Joint Surg Am. 2020;102(13):e69.
7. Samsami M, Zebarjadi Bagherpour J, Nematihonar B, Tahmasbi H. COVID-19 Pneumonia in Asymptomatic Trauma Patients; Report of 8 Cases. Arch Acad Emerg Med. 2020;8(1):e46.
8. Catellani F, Coscione A, D'Ambrosi R, Usai L, Roscitano C, Fiorentino G. Treatment of Proximal Femoral Fragility Fractures in Patients with COVID-19 During the SARS-CoV-2 Outbreak in Northern Italy. J Bone Joint Surg Am. 2020;102(12):e58.
9. Maniscalco P, Poggiali E, Quattrini F, et al. Proximal femur fractures in COVID-19 emergency: the experience of two Orthopedics and Traumatology Departments in the first eight weeks of the Italian epidemic. Acta Biomed. 2020;91(2):89-96.
10. Lv H, Zhang Q, Yin Y, et al. Epidemiologic characteristics of traumatic fractures during the outbreak of coronavirus disease 2019 (COVID-19) in China: A retrospective & comparative multi-center study. Injury. 2020;S0020-1383(20)30522-2.
11. Chen W, Lv H, Liu S, et al. National incidence of traumatic fractures in China: a retrospective survey of 512 187 individuals. Lancet Glob Health. 2017;5(8):e807-e817.
12. Lange SJ, Ritchey MD, Goodman AB, et al. Potential Indirect Effects of the COVID-19 Pandemic on Use of Emergency Departments for Acute Life-Threatening Conditions - United States, January-May 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):795-800.
13. Iyengar K, Vaish A, Vaishya R. Revisiting conservative orthopaedic management of fractures during COVID-19 pandemic. J Clin Orthop Trauma. 2020;11(4):718-720.
14. Dipartimento della protezione civile italiana. http://opendatadpc.maps.arcgis.com/apps/opsdashboard/index.html#/b0c68bce2cce478eaac82fe38d4138b1. Accessed on 7/29/2020
15. Court-Brown CM, McQueen MM. Global forum: fractures in the elderly. J Bone Joint Surg Am. 2016;98(9):e36–e42.