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Background: Spinal injuries following an air crash can be fatal, and recognizing the patients who need immediate attention and early management could save those patients from ending up with lifelong disabilities and other consequences. However, taking appropriate actions in a pandemic situation presents additional challenges. We present our report of air crash victims with spinal injuries, along with their patterns, morphology, management, and outcomes during the COVID-19 pandemic.Methods: An analysis was performed on the spinal injuries of victims of the Boeing 737 crash landing at the Karipur Airport (Calicut International Airport, Kerala, India) who were treated at a tertiary care referral hospital in August 2020. Details of the initial triage, patterns of injury, morphologies, mechanisms, management principles, and outcomes at 9 months postinjury were recorded and analyzed.Results: Of the 47 patients received at our center, 44 survivors were triaged and 13 patients (29.5%) were identified to have spinal injuries of varying severities. The majority of the injuries were chance fractures at the lumbar level, followed by burst and compression fractures. A total of 6 patients underwent surgery, following all COVID-19 guidelines based on priority. All survivors had positive outcomes with our management. No complications such as secondary infections, worsening of neurological deficits, or implant failures were recorded.Conclusion: A high incidence of spinal injuries is seen in air crash victims. Early prioritized surgical management in selected patients provides excellent outcomes. Disaster management during a pandemic situation is a difficult task, where proper planning and execution is necessary to provide optimal results.

Purpose The survival rate of a Flight crash is quite low and this makes the Calicut incident unique. Management of flight crash victims is itself a herculean task and during COVID-19 pandemic it poses another challenge to the treating team since all the patients are under quarantine and the treatment protocols are not well defined. Methods On 7/8/2020 at around 7.41 pm, Air India Express aircraft from Dubai to Calicut, while landing on the runway lost its control and skidded off the runway and broke into three parts. We report a detailed analysis of orthopaedic injury patterns and difficulties encountered in the management of these patients with full personal protective equipment (PPE) kit during COVID-19 pandemic. Results 47 patients from the crash site were brought to our hospital and 38 of them were admitted under the orthopaedic department. 74 doctors and 76 trained nurses along with 58 supporting staff were involved in the management of the mass casualty during that night. Most of the patients suffered injuries to lower extremity and spine which included 11 femur, 13 tibial and 12 spine fractures. Average union time was around 3 months for fractures. Delayed union of fracture femur, avascular necrosis of talus and nonunion of 5th metatarsal base fracture were the reported complications. Surgical site infection was observed in two patients. Conclusion Trauma management team should be prepared to manage difficulties encountered during identification, communication, and treatment of the disaster victims during this COVID-19 era.