Impact of COVID-19 on Fracture Incidence in Germany: A Comparative Age and Gender Analysis of Pre- and Post-Outbreak Periods

Abstract

In March 2020, Germany imposed a nationwide lockdown to curb the spread of COVID-19, prompting questions about the impact on the incidence of common fractures. This study examined 15 fracture types in pre-outbreak (2010–2019) and post-outbreak (2020–2021) periods, using data categorized by age (18–64 years, >65 years) and sex (male, female). Linear regression assessed annual growth rates, and mean fracture numbers were compared across periods for significant differences. Results indicated a positive correlation between fracture incidence rates and time for various types, such as cervical, thoracic, lumbar, and pelvic spine fractures, rib fractures, femoral neck, pertrochanteric femur, femoral shaft, and ankle fractures. Frequencies of proximal humerus, distal radius, femoral neck, pertrochanteric femur, femoral shaft, and ankle fractures in 2020 and 2021 were within predicted ranges from previous years. However, rib fractures and spinal fractures (cervical, thoracic, lumbar, and pelvic spine) occurred less frequently during this time. Notably, this study found a consistent decline in most fracture types for individuals aged 18–64 after the pandemic’s onset, while the fracture incidence of hip fractures, often referred to as fragility fractures, for those over 65 remained unchanged. Fibula fractures showed the most considerable decrease in both age groups. In conclusion, the COVID-19 pandemic substantially impacted fracture incidence, with lower rates among individuals under 65 and unchanged fragility fractures in the elderly population.

Assessment of functional fitness impacted by hospital rehabilitation in post-stroke patients who additionally contracted COVID-19

“…It was also observed that during the COVID-19 pandemic older people more frequently experienced low-energy injuries (due to falls or slips) ( Gawronska & Lorkowski, 2021 ). Similar findings were reported by researchers who investigated the effect of COVID-19 on the incidence of fractures in Germany, and observed a higher incidence of fractures after the outbreak of the pandemic ( Heinz et al, 2023 ). A study has also shown that patients with stroke combined with COVID-19 present poorer functional performance compared to non-COVID-19 patients with stroke ( Ntaios et al, 2020 ).…”

Impact of Covid-19 on the Profile, Seasonality and Incidence of Femur Fracture Cases in Brazilian Young Adults

“…It began on March 11, 2020 and ended on May 5, 2023 by the World Health Organization (Baloch et al, 2020;Ciotti et al, 2020;Souto, 2020). In addition to the direct impact of the disease, the health system faced a series of unprecedented logistical and care challenges (Alencar et al, 2022;Silva et al, 2022;Heinz et al, 2023).…”