The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on daily life. Restrictions imposed to help minimise virus transmission have limited both population movement and employment, as well as altering the potential mechanisms of high-energy trauma. The objective of this study was to assess the impact of the COVID-19 pandemic on pelvic and acetabular trauma. Materials and methodsA retrospective observational study of the incidence, causality, patient profile, fracture morphology, and treatment strategy of pelvic and acetabular trauma managed in a national tertiary referral specialist pelvic and acetabular centre between the 1 st of March and 1 st of August 2020 was undertaken and compared to corresponding time periods in the two preceding years. ResultsA total of 78 patients were referred for management following pelvic and acetabular trauma during the study period with a mean age of 52 years (SD +/-24.2). Overall, 45% and 42% of patients were referred following isolated pelvic or acetabular fractures respectively. The most frequent mechanism of injury was a fall from height (>1m) (42%), with 53% of patients suffering from concomitant injuries and 32% requiring surgical management. While there was a statistically significant difference in mechanism of injury (P=0.026), there was no significant difference in overall incidence, fracture types, incidence of concomitant injuries, or overall proportion requiring surgical intervention during the study period when compared to previous years. ConclusionWhile some variation in the mechanisms of injury have been observed, the overall incidence, patient, fracture, and injury profiles associated with pelvic and acetabular trauma appear to have remained consistent during the COVID-19 pandemic. Additionally, the number and proportion of those requiring surgical treatment of these fractures have remained stable. Understanding the continued burden of these potentially severe injuries may help guide injury prevention, treatment, and resource allocation as the pandemic continues.

Skin puckering is a feature observed in fractures that undergo large displacements at the time of initial injury and occur as a result of adherence of the dermal tissues to the underlying fracture fragment. Herein, we discuss the interesting case of a 47-year-old male who suffered a comminuted tibial shaft fracture which resulted in marked pretibial skin puckering prior to fracture reduction with striking corresponding images noted on computerised tomography (CT) scanning.

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Equestrian sport in Ireland is an extremely popular sport undertaken by many and considered by most to be a relatively safe pursuit. The aim of this study was to identify the incidence and severity of pelvic injuries in female amateur horse riders, referred to the Irish National Pelvic & Acetabular Referral Centre. The study was particularly focused on women of childbearing age, given the potentially catastrophic adverse outcomes associated with these injury patterns and the profound impact these injuries can have on both lifestyle and future childbirth. We conducted a retrospective review of all patients referred to the National Centre for Pelvic and Acetabular Trauma over a 30-month period from January 2018 through July 2020. Information was garnered from the national referral database, patient specific chart analysis and a review of images from the National Integrated Medical Imaging System (NIMIS). We identified a cohort of 16 females of childbearing age who sustained pelvic injuries while horse riding during this period. Four of these patients warranted surgical intervention, and with a minimum 6-month follow-up period, all were progressing satisfactorily. A review of the literature outlined the potential for profound adverse outcomes in young females suffering pelvic fractures, particularly in relation to genitourinary and pregnancy related complications. Caution should be exerted by all women of childbearing age engaging in recreational equine pursuits, and we would emphasise the importance of safety messaging and increased protective equipment for these athletes.

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