How hand and wrist trauma has changed during covid-19 emergency in Italy: Incidence and distribution of acute injuries. What to learn?

Abstract

Background: the purpose is to gather and analyze the statistical datas of wrist and hand injuries admitted to the Hand and Reconstructive Microsurgery and Replantation Hub center of Careggi Hospital, Florence during the first two months of COVID-19 epidemic in Italy. The Authors investigated how the drastic changes in daily activities modified the epidemiology of hand trauma lesions. Methods: The Authors analyzed the characteristics of hand and wrist traumatic disorders during the months of February and March comparing 2019 to 2020. Collected data included age distribution, traumatic etiology, diagnosis and type of surgical procedures. Results: The total number of orthopedic and trauma patients significantly decrease in 2020 compared to 2019 (3360 vs 1470). The number of hand and wrist injuries didn't show a significant difference between 2019 and 2020 instead (192 vs 131). The overall number of patients hospitalized and surgically treated at our Operative Unit (OU) was 168 in 2019 and 120 in 2020. Male patients resulted prevalent (60,7 M vs 39,3F/2019; 63,2 M vs 36,8F/2020). In terms of patient age, in 2020 we registered a significant reduction of cases in the 20-35-year-old age group and a significant increase in the 51e65 and 66-80-year-old age groups. Traffic-related, sport-related and fortuitous injuries significantly decreased in 2020, while the number of domestic accidents significantly increased. Analyzing the Hospital Discharge Records (HDR), we found a significant increase in the number of proximal and middle phalanx fractures; no significant differences were found for other kinds of discharge diagnosis. As for the choice of surgical treatment options, no differences were found between 2019 and 2020. Conclusion: Even during drastic movement restrictions and the prolonged suspension of work and leisure activities secondary to COVID-19 epidemic in 2020, hand and wrist traumas rate remained almost the same compared to the same period of the previous year. Nevertheless, a significant change in the etiology and patient age was registered. In fact, sport and traffic-related traumas decreased respect to domestic traumas, while the previous prevalent involvement of young adults was surpassed by accidental hand traumas in the elderly and active adults.

The global burden of trauma during the COVID-19 pandemic: A scoping review

“…A reduction in trauma occurring secondary to RTCs was reported in the UK, 10 , 20 , 45 , 49 US 17, 26, 40, 51, 52, 55 , New Zealand, 12 Australia, 31 , 50 India, 53 , 57 Iran, 37 Hong Kong 58 and Europe. 13 , 19 , 22 , 36 , 59 , 60 These reductions reached statistical significance in Jacob et al‘s Australian centre (34% v 46%, p = 0.025), and Sherman et al‘s US centre (42% v 49%, p = 0.03). An increase in injuries from RTCs in children was reported by Bram et al in the US (5.2% v 1.8%) 11 and UK by Sugand et al (2% v 1%).…”

“…The reported proportion of patients undergoing closed reduction and open reduction and internal fixation (ORIF) and external fixation remained largely comparable before and after the pandemic in reporting centres based in Australia, 31 US, 11 Europe 59 and the UK. 10 , 54 …”

Epidemiology of distal radius fractures in children and adults during the COVID-19 pandemic – a two-center study

“…Distal radius fractures constitute a social problem [1][2][3][4][5][6][7][8][9][10][11][12][13]. The COVID-19 pandemic has had a considerable impact on the lives of both adults and children around the world [13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Some schools have been closed, causing children to stay at home, and some adults work from home.…”

“…Hashmi reported a 50% decrease in both elective and emergency admissions to orthopedic wards, with no changes in either the mean age or male-to-female ratio in patients in the COVID-19 pandemic period in comparison with the relevant prepandemic figs [16].. Yu et al observed a 42% decrease in the number of patients with fractures seen at one of the orthopedic wards in China during the COVID-19 epidemic [17]. Poggetti et al reported a 28.6% decrease in the number of patients undergoing surgery due to hand and wrist trauma in one of Italian hospitals during the COVID-19 pandemic [18]. In one of the Turkish hospitals, the total number of fractures recorded during the COVID-19 pandemic was by 61.6% lower than the number of fractures recorded in 2019 [20].…”

“…The COVID-19 pandemic altered the healthcare in the whole world in the year 2020 [13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Although the causative coronavirus (SARS-CoV-2) can infect both adults and children, the majority of children have mild or asymptomatic course of the disease [13].…”