Search Results (4)

Objectives: this study aimed to compare the admission volume and characteristics of patients with traumatic orthopaedic injuries before, during, between, and after the COVID-19 lockdowns in metropolitan Victoria, Australia. Methods: A multi-centre, registry-based cohort study with an interrupted time series analysis was conducted using data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) for patients with a date of injury from January 2017 to June 2022. Weekly admission volume, injury event characteristics, and in-hospital outcomes were analysed before, during, between, and after the two periods of COVID-19 lockdowns in metropolitan Melbourne (i.e., five periods). Results: During the first week of lockdown in Victoria (L1), the number of weekly orthopaedic trauma admissions declined by 24% relative to the preceding week, IRR 0.76 (95%CI 0.67, 0.87). However, the volume of admissions during the subsequent lockdown (L2) approximated pre-COVID levels. An immediate increase in orthopaedic trauma admissions occurred during the intermission (time between lockdowns) and post-COVID periods by 33% and 20%, respectively, compared to the preceding week. During periods of lockdown, patients were older (61 versus 58 years old), and a higher proportion were injured at home (38% versus 28%); fewer due to motor vehicle collisions (8% versus 11%). The pattern of injury by intent, body region injured, injury severity, and in-hospital mortality were unchanged. Conclusions: the impact of COVID-19 lockdowns on the volume and characteristics of hospitalised orthopaedic trauma was not uniform across consecutive lockdowns, but favoured injuries that occurred at home. Full article

Background and Objective: On March 2020, our country became a protected area due to the COVID-19 pandemic. The consequences of COVID-19 on trauma surgery were great. We aimed to evaluate the activity of the Trauma Centre of a highly populated suburban area over 30 days starting from the first day of restrictions, to compare it with the same period of 2019 and 2022 and to evaluate whether a progressive return to normality has taken place. Materials and Methods: All patients older than 18 years managed in our Trauma Unit between 8 March 2020 and 8 April 2020 (the first COVID-19 period) were compared to the same period of 2019 (a COVID-19 free period) and 2022 (the second COVID-19 period). Clinical records were examined. Five categories of diagnoses and six mechanisms of injury were distinguished. Results: There were 1351 patients [M:719–F:632; mean age (SD):49.9 (18.7)], 451 [M:228–F:223; mean age (SD):55.9 (18.4)] and 894 [M:423–F:471;mean age (SD):54.1 (16.7)] in the COVID-19 free and in the first and second COVID-19 periods, respectively (p < 0.05). In 2020, the most significant decrease was registered for sprains/subluxations (80%); contusions decrease by 77% while fractures decrease only by 37%. The lowest reduction was found for dislocations (26%). In 2022, dislocations decreased by only 16% and both fractures and sprains decreased by about 30% with respect to the pre-pandemic period. Patients with minor trauma (contusions) were half compared to 2019. Accidental falls remain the most frequent mechanism of injury. The incidence of proximal femur, proximal humerus and distal radius fractures remained almost unchanged during both pre-pandemic and pandemic periods. Conclusions: COVID-19 has markedly altered orthopaedic trauma. Injuries related to sports and high energy trauma/traffic accidents drastically reduced in 2020; however, we are slowly going back to normality: the same injuries increased in 2022 due to the progressive easing of restrictions. Elderly fractures related to accidental falls remained unchanged. Full article

The COVID-19 pandemic and the resulting restrictions led to a reduced number of surgeries. This study examines its impact on the course of treatment and clinical outcome of surgically treated paediatric upper limb fractures during that specific period. This retrospective cohort study evaluated all children aged 0–18 years presenting with an upper limb fracture treated surgically at the level 1 trauma centre of the University Clinic of Orthopaedics and Trauma Surgery of Vienna within lockdown from 16 March to 29 May 2020 (definition applied through corresponding legislation) compared to the same period from 2015 to 2019. A total number of 127 children (m:63; f:44) were included. The lockdown did not lead to a significant increase in complications during and after initial surgery. Time until removal of implant was not significantly prolonged (p = 0.068; p = 0.46). The clinical outcome did not significantly differ compared to previous years. The experience of a level 1 trauma centre showed that despite reduced surgical capacity during the COVID-19 pandemic, no negative differences concerning course of treatment and clinical outcome of surgically treated paediatric upper limb fractures were present. These findings are still of importance since the COVID-19 pandemic continues and several countries in Central Europe are currently under their fourth lockdown. Full article

Background: This study examined the effect of the COVID-19 pandemic and the resulting decrease in the incidence of various categories of injuries, with the main focus on fractures and mild traumatic brain injuries in a paediatric population. Methods: This retrospective cohort study evaluated all children from 0 to 18 years of age presenting with an injury at the level 1 trauma centre of the University Clinic of Orthopaedics and Trauma Surgery in Vienna during the lockdown from 16 March to 29 May 2020 compared to records over the same timeframe from 2015 to 2019. Results: In total, 14,707 patients with injuries were included. The lockdown did not lead to a significant decrease in fractures but, instead, yielded a highly significant increase in mild traumatic brain injuries when compared to all injuries that occurred (p = 0.082 and p = 0.0001) as well as acute injuries (excluding contusions, distortions and miscellaneous non-acute injuries) (p = 0.309 and p = 0.034). Conclusions: The percentage of paediatric fractures did not decrease at the level 1 trauma centre, and a highly significant proportional increase in paediatric patients with mild traumatic brain injuries was observed during the COVID-19 lockdown. Therefore, medical resources should be maintained to treat paediatric trauma patients and provide neurological monitoring during pandemic lockdowns. Full article