Effects of easing shelter-in-place restrictions and the lingering COVID-19 pandemic on orthopaedic trauma at a community level 2 trauma center

Abstract

Objectives: Evaluate the effect of easing "shelter-in-place" restrictions and coronavirus-2019 (COVID-19) cases on orthopaedic trauma encounters (OTEs) at a community level II trauma center.Methods: A retrospective analysis was conducted of OTEs from March-June of 2016 to 2020. Injuries were classified by high or low severity. Admission and surgical intervention rates were also compared year to year. Data were statistically analyzed and compared with external data for traffic counts near the hospital and COVID-19 cases in Michigan as well as a timeline for enacting and easing of shelter-in-place orders in the state of Michigan.Results: There was no difference in the number of OTEs May to June, 2020 compared with the average of those same months 2016 to 2019. March to June, 2020 showed no change in proportion of injury severity, admissions, or surgical interventions when compared with the average of March-June, 2016 to 2019, although the overall quantity of each was decreased in March and April. A significant negative correlation was found between the daily number of COVID-19 cases in Michigan and OTEs.Conclusions: The quantity of OTEs normalized to pre-COVID-19 levels in May and June of 2020 compared with 2016 to 2019 despite a previously documented 45.1% drop in March and April. A negative correlation was noted between the number of reported Michigan COVID-19 cases and volume of OTEs. There were no significant changes noted to admission rates or rates of surgical intervention on OTEs throughout the time period studied.

Hip Fracture Surgery Volumes Among Individuals 65 Years and Older During the COVID-19 Pandemic

“…With the exception of fall 2020 when COVID-19 cases were low, hip fracture surgery volumes among older individuals were lower than 2 years previously starting with the spring 2020 surge until the COVID-19 vaccine became widely available in spring 2021. This pattern contrasts with that seen in the general population, in which fracture incidence returned to baseline once shelter-in-place orders were lifted in summer 2020 …”

“…Hip fractures in individuals 65 years or older are common (>250 000 per year in the US) and consequential (1-year mortality rate, 12%-37%) . Prior studies of orthopedic trauma (ie, fractures) in the general population documented a decline at the beginning of the COVID-19 pandemic in March-April 2020, followed by a return to baseline by summer 2020 once shelter-in-place orders were lifted . We assessed hip fracture surgery volumes among older individuals during the pandemic.…”